The Can’t Miss Diagnosis series focuses on diseases that are relatively rare, difficult to diagnose, and catastrophic when diagnosis and treatment are delayed. The key to good outcomes for these diseases is to be prepared in advance to recognize and treat them, and to address individual cases with a high index of suspicion for disorders that are infrequently seen.
Aortic dissection is rare, but complications develop rapidly, and the outcome is often fatal. In an aortic dissection, a break in the inner wall of the aorta allows blood to surge between the inner and outer layers of the aortic wall. The blood under pulse pressure dissects the middle layer of the aorta, creating a propagating split in the aortic wall.