From Neck Pain to a Life-Threatening Condition: A Case Report

Abstract

A 30-year-old man presented with sudden neck pain radiating to his chest. He appeared anxious, pale, and clammy. Despite unremarkable history and clinical examination, elevated D-dimers led to a computed tomography pulmonary angiography (CTPA), which ruled out pulmonary embolism but revealed a widened ascending aorta. Further family history indicated significant vascular disease in the patient’s father. Initial treatment included analgesia and control of heart rate and blood pressure. The patient was then transferred to a cardiothoracic center, where a detailed CT aortogram and transesophageal echocardiography confirmed an acute type A aortic dissection. This case underscores the diagnostic challenges of aortic dissection, highlighting the need for thorough clinical evaluation and suggesting future use of tools like the Aortic Dissection Detection-Risk Score (ADD-RS) with D-dimers for guidance.