Discussion
Commercial aircraft generally use flight levels ranging from 30,000 to
40,000 feet (about 9,000 to 12,000 meters). At this altitude, external
effects begin to cause changes in the organism [2]. Depressurization
can occur when there is a loss of pressure. This can be fast or slow,
being the result of a malfunction in the system or a leak in the
aircraft fuselage.
In cases of depressurization, the symptoms are headache, fatigue
dizziness, nausea vomiting, lack of concentration/confusion extremity
paresthesias and chest pain [3]. In the case reported herein, it was
a slow depressurization, the patient was subjected to intense emotional
stress and a feeling of panic. During this period the patient
experienced atypical chest discomfort. 24 hours latter the patient
started experiencing chest pain radiating to the back associated with
extreme tiredness. The diagnosis of Stanford type A AADat ED was made.
To the best of our knowledge, there is only one clinical case described
in a fighter pilot instructor who developed an AAD at a height of 230 m
during left drill action of acute spiral down movement from 2000‐m high
attitude driven by an air force pilot trainee[1J.