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.