Aortic dissection: A life-threatening stroke mimicker

Aortic dissection is a life-threatening cardiovascular emergency, and despite medical advances, its diagnosis is often shrouded by the diversity of its clinical presentation. Physician must have high index of suspicion, especially in those with unusual combination of features that may occur in acute painless dissection. We report a case of a man presented with right-sided weakness and syncope associated with pulse deficits at multiple levels. Physical examination of the lower limb is consistent with acute limb ischemia. Computed tomogram thorax done after emergency embolectomy revealed extensive Stanford type A aortic dissection down to the level of abdominal aortic bifurcation. The diagnosis of aortic dissection is delayed due to his atypical symptoms, which is likely resulted from malperfusion syndrome of aortic dissection.