# Spontaneous Aortic Rupture: A Case Report

## TL;DR

This case report describes a rare aortic rupture in an elderly woman with atypical symptoms, highlighting the importance of considering acute aortic syndrome in similar patients.

## Contribution

The paper presents a novel case of spontaneous aortic rupture with an atypical presentation and emphasizes diagnostic approaches to avoid missed diagnoses.

## Key findings

- Aortic rupture can present with nonspecific symptoms like throat pain and normal vital signs.
- Emergency physicians should consider acute aortic syndrome in elderly patients with hypertension and ischemic changes on ECG.
- Computed tomography is critical for diagnosing aortic rupture in atypical cases.

## Abstract

Acute aortic syndrome (AAS) includes the disease processes of aortic dissection, penetrating atherosclerotic ulcer, and intramural hematoma. This case demonstrates an atypical presentation of the disease and offers approaches to potentially prevent missed diagnoses.

An 87-year-old female with hypertension and Alzheimer’s dementia presented to the emergency department with stable vital signs and a chief complaint of throat pain. Initial work-up was significant for ischemia on electrocardiogram and elevated troponin. Computed tomography of the soft tissue neck revealed evidence of a ruptured aorta.

Aortic rupture is a fatal complication of AAS. In an elderly patient with a history of hypertension, ischemic changes on electrocardiogram, and nonspecific pain, AAS should be on the emergency physician’s differential even in the setting of a benign or limited history and exam.