Indian Journal of Critical Care Case Report

Register      Login

VOLUME 3 , ISSUE 3 ( May-June, 2024 ) > List of Articles


A Radiological Artifact Mimicking Aortic Dissection in Emergency Room: A Diagnostic Challenge

Amit K Rohila, Ankur Gupta, Ankur Sharma, Rahul Choudhary, Mahaveer S Rodha, Rengarajan Rajagopal

Keywords : Aortic artifact, Acute coronary event, Aortic dissection, Case report

Citation Information : Rohila AK, Gupta A, Sharma A, Choudhary R, Rodha MS, Rajagopal R. A Radiological Artifact Mimicking Aortic Dissection in Emergency Room: A Diagnostic Challenge. 2024; 3 (3):71-73.

DOI: 10.5005/jp-journals-11006-0103

License: CC BY-NC 4.0

Published Online: 03-05-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Introduction: Aortic dissection can be challenging to diagnose in the emergency room. The diagnosis of aortic dissection in an emergency depends upon the clinical findings and computed tomography (CT) aortogram to look for the dissection. This case describes how a radiological artifact mimicked aortic dissection and posed a diagnostic challenge. Case description: We discuss the case of a 52-year-old lady who complained of chest pain and discomfort upon presenting to the emergency room with a significant blood pressure difference between both upper limbs, giving an impression of an acute coronary event and possible aortic dissection. Bedside two-dimensional (2D) echocardiography was done, which showed a suspected aortic flap. On a CT aortogram, a dissection was initially seen, which was later found to be an artifact of the aorta, causing a diagnostic dilemma. Conclusion: This case describes the importance of knowing this radiological mimicker and considering other differentials before diagnosing aortic dissection.

PDF Share
  1. Ayrik C, Cece H, Aslan O, et al. Seeing the invisible: painless aortic dissection in the emergency setting. Emerg Med J 2006;23(3):e24. DOI: 10.1136/emj.2004.021790
  2. Ince H, Nienaber CA. Diagnosis and management of patients with aortic dissection. Heart 2007;93(2):266–270. DOI: 10.1136/hrt.2005.078550
  3. Levy D, Goyal A, Grigorova Y, et al. Aortic Dissection. 2023. StatPearls
  4. Braverman AC. Acute aortic dissection: clinician update. Circulation 2010;122(2):184–188. DOI: 10.1161/circulationaha.110.958975
  5. Starck CT, Hammerschmidt R, Falk V. Acute aortic syndrome: aortic dissection—ascending aortic dissection. ESC Cardio Med 2018;2594–2597. DOI: 10.1093/med/9780198784906.003.0616_update_001
  6. Bossone E, Rampoldi V, Nienaber CA, et al. Usefulness of pulse deficit to predict in-hospital complications and mortality in patients with acute type A aortic dissection. Am J Cardiol 2002;89(7):851–855. DOI: 10.1016/s0002-9149(02)02198-7
  7. Ropp A, Frazier AA, Gelfand B, et al. The Dean effect: an aortic arch flow artifact mimicking dissection. Radiol Cardiothorac Imaging 2022;4(1):e210229. DOI: 10.1148/ryct.210229
  8. Sanders RJ, Hammond SL. Management of cervical ribs and anomalous first ribs causing neurogenic thoracic outlet syndrome. J Vasc Surg 2002;36(1):51–56. DOI: 10.1067/mva.2002.123750
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.