INTRODUCTION
Aortic dissection (AD) is a rare but life-threatening event in which a
tear in the intima of the aorta allows circulating blood to enter
between the layers of the vessel.1 Stanford Type A
AD’s involve the aorta proximal to the origin of the left subclavian
artery and classically present with pathognomonic ‘tearing’ chest pain,
though some cases may present more insidiously.2 These
dissections are associated with a 1-2% increased mortality rate per
hour, leaving fastidious diagnosis through either computed tomography
angiography (CTA) or echocardiography a critical component to
survival.1,3 Treatment consists of pain control, beta
blockade for heart rate, blood pressure management, and typically
emergent surgery.1
While hypertension and connective tissue disorders are well-recognized
risk factors for AD, other risk factors, such as pregnancy, may not be
thoroughly understood. Nonetheless, child-bearing remains a critical
consideration, as approximately 50% of the dissections seen in women
under 40 years of age actually occur during
pregnancy.1,4 Both diagnosis and management of AD vary
in the pregnant population as well, with altered maternal physiology and
concern for fetal well-being necessitating special consideration from
clinicians. Although an abundance of literature exists pertaining to
AD’s in the non-pregnant population, data is inadequate regarding how
this life-threatening condition should be clinically approached in
pregnant patients. We sought to present a rare case of an AD in a
third-trimester pregnant patient.