Acute aortic dissection in postpartum

Description

A Caucasian woman aged 35 years, with no relevant personal history or history of drug abuse and an uneventful pregnancy, presented in the emergency room (ER) at 34 weeks of gestation, with preterm premature rupture of membranes. On physical examination, she had elevated blood pressure and bilateral peripheral oedema. An extensive blood panel was performed, providing the diagnosis of pre-eclampsia. Four hours after admission, she had a vaginal delivery and, 36 hours later, discharged herself against medical advice. A few hours later, she returned to the ER, reporting of severe thoracic pain of sudden onset, sweating and nausea. Her vitals were within normal range, and peripheral pulses were present and symmetrical.

Suspecting a pulmonary embolism, a thoracic CT was performed (figures 1–3), showing 'extensive dissection of the ascending aorta, extending from the aortic root to the origin of the celiac artery. No aneurism is...

http://casereports.bmj.com/cgi/content/short/2016/nov08_2/bcr2016218236?rss=1