International Journal of Research in Medical Sciences | August 2016 | Vol 4 | Issue 8 Page 3644 International Journal of Research in Medical Sciences Khan F et al. Int J Res Med Sci. 2016 Aug;4(8):3644-3646 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Case Report Stanford type B aortic dissection in a middle aged female in civil hospital Karachi, Pakistan Fahad Khan 1 *, Sundus Akhtar 2 , Syeda Ramsha Zaidi 2 INTRODUCTION Aortic dissection is a life threatening condition described as disruption of the medial layer of the wall of the aorta provoked by intramural bleeding, resulting in separation of the aortic wall layers and subsequent formation of a true lumen and a false lumen with or without communication. It is much more common in males with a male to female ratio of 2:1 to 5:1. It is estimated to occur at a rate of 3 to 4 cases per 100,000 persons per year. 1 Aortic dissection is caused by a deterioration of the inner lining of the aorta. There are a number of conditions that predispose a person to develop defects of the inner lining, including high blood pressure, Marfan's disease, Ehlers- Danlos syndrome, connective tissue diseases, and congenital defects. A dissection can also occur accidentally following insertion of a catheter, trauma, or surgery. 2 The case we document here is an unusual case of aortic dissection Stanford type B who presented with shortness of breath. CASE REPORT A 50 year old lady known case of hypertension for last 15 years presented with shortness of breath and chest pain for last 2 years on exertion only and now occurring at rest for last 3 days. She also has a history of orthopnea and paroxysmal nocturnal dyspnea. For last 3 days she also developed mild chest pain. On examination, her blood pressure was found to be 160/70 in right arm and 140/70 in left arm and pulse was 68 BPM and a diastolic murmur was auscultated in aortic area and rest of the systemic examination was insignificant. Initial investigations showed normochromic normocytic anemia with Hb of 10.4 g/dl, HCT of 30.9, WBC of 7.0×10e 3 /uL. Her creatinine was 0.9 mg/dL, ABSTRACT Aortic dissection is a potentially catastrophic illness that presents very rarely usually in sixth or seventh decade. There are two types of dissection; Stanford type A, which is treated surgically while type B is managed pharmacologically. Mortality is high for both types of aortic dissections. However, when an aortic dissection is detected early and treated promptly, the chance of survival greatly improves. It usually presents as a sharp tearing pain radiating to interscapular region but can also present atypically hence a high index of clinical suspicion is needed. We register a case a 50 year old female who was a known case of HTN presented with complain of dyspnea. On further investigation she was found to have aortic dissection involving descending aorta. She was managed conservatively but unfortunately died. Keywords: Aortic dissection, Descending aorta, Stanford type B, Dyspnea, Atypical 1 Department of Cardiology, Civil hospital Karachi, Pakistan 2 Medical Student, Dow Medical College, Karachi, Pakistan Received: 19 June 2016 Accepted: 08 July 2016 *Correspondence: Dr. Fahad Khan, E-mail: khanfahad05@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20162347