Transient global amnesia: an atypical presentation of acute aortic dissection

Aortic dissection (AD) is a cardiovascular emergency whose most frequent symptom is chest pain. However, clinical presentation can also be varied and atypical. In the present study we report a case of painless AD, which resulted in a sudden memory loss at presentation. Physical examination and laboratory tests regarding the patient did not show any abnormal findings and a benign transient global amnesia was diagnosed. The day after being discharged, the patient came back to the emergency department because a recurrent episode of severe memory impairment occurred. This time, additional clinical and laboratory signs suggested clinical suspicion of AD. A chest computed tomography angiogram was performed and an extensive AD type A involving carotid and iliac arteries was found. Our case report shows that acute aortic dissection diagnosis can be difficult if clinical presentation is atypical and must be assessed in the light of various clinical signs and laboratory data.