Painless Aortic Dissection with Catastrophic Consequences Presenting as Sudden Loss of Consciousness with no Prodromal Symptoms

This case report presents a complex clinical scenario involving a 71-year-old female with aortic dissection accompanied by hypotension. The patient’s initial presentation of sudden loss of consciousness unveiled a large pericardial effusion and cardiac tamponade, leading to emergency surgery. Subsequent diagnostic findings revealed an intramural haematoma with an intimal tear in the ascending aorta. Postoperatively, the patient experienced an ischaemic stroke, necessitating prompt neurology consultation and treatment. This report underscores the significance of early recognition and collaborative management in achieving positive patient outcomes. LEARNING POINTS: Early identification of aortic dissection symptoms, such as sudden loss of consciousness and hypotension, is crucial for effective management. Managing aortic dissection involves a multidisciplinary effort with emergency medicine, cardiology and surgical teams working together for optimal patient outcomes. After aortic dissection surgery, staying attentive to potential neurological complications such as ischaemic strokes is essential.