An Alleged Sepsis Syndrome turned out to be Aortic Dissection

Aortic dissection is an emergency condition in which there is a tear in the wall of the major artery carrying blood from the heart. As the tear extends along the wall of the aorta, blood flows within the layers of the vessel, and leads to aortic rupture or decreases perfusion in other vital organs. Acute aortic dissection might be associated with higher mortality rates and usually represents a medical emergency. In this case we described aortic dissection in a 68 year old man, with clinical presentation of high grade fever, confusion, dyspnea and hypertension and initially misdiagnosed as sepsis syndrome.

Notably, a high index of suspicion is required to diagnose aortic dissection and it is more challenging in elderly patients, referred to atypical symptoms and various underlying organ dysfunctions.