Painless long-segmental aortic dissection diagnosed by echocardiography: a case report of a diagnostic conundrum with potentially poor outcome

Aortic dissection is a life-threatening condition with a higher mortality rate. Early diagnosis enhances the prognosis of this disease; however, while chest pain is the most common symptom, we can occasionally find asymptomatic patients, making diagnosis more difficult and even missed, it is an uncommon entity with few data in the literature based exclusively on reported cases. Here, we report a case of completely asymptomatic long segmental aortic dissection in a 66-year-old male, with a recent history of controlled hypertension. The diagnosis was made by noninvasive methods, and the patient was referred for surgical treatment. Aortic dissections that are painless provide a significant challenge to physicians in terms of improving prognosis for this frequently misdiagnosed yet lethal illness. The main goal of this report is to bring attention to the misdiagnosed signs and symptoms of aortic dissection.