Huge Aortic Dissection Discovered by Point of Care Ultrasonography (POCUS): A Case Report

Huge Aortic Dissection Discovered by Point of Care Ultrasonography (POCUS): A Case Report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Huge Aortic Dissection Discovered by Point of Care Ultrasonography (POCUS): A Case Report Ihab Alasasfeh, Nansi M Abdelrahim, Emman Bani Nasr, Qutaiba Sabbah, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7684568/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The aorta is the body’s largest blood vessel, and its primary function is to carry oxygen and blood from the left ventricle to other body organs. Anatomically, the aorta is divided into four parts: the ascending aorta, the aortic arch, the descending thoracic aorta, and finally, the abdominal aorta (1). The worldwide incidence rate estimate of Acute aortic dissection (AAD) was found to be 4.8 per 100,000 individuals/year (2). Aortic dissection is a life-threatening condition, often presenting with chest pain. However, atypical presentations, including abdominal pain, may occur. In this case report of a 51-year-old male patient, we will show the important role of using Point of care ultrasonography (POCUS) as a part of clinical examination in unstable patients with atypical presentations in the Emergency department. POCUS Point-of-care ultrasound Aortic dissection Figures Figure 1 Figure 2 Figure 3 Figure 4 Background Aortic dissection is an emergent medical condition, generally affecting the elderly, characterized by a separation of the aortic wall layers and subsequent creation of a pseudolumen that may compress the true aortic lumen dissection (3,4). Aortic dissection is a life-threatening condition, often presenting with chest pain. However, atypical presentations, including abdominal pain, may occur. We report a case of a 51-year-old male with a known history of hypertension and migraines who presented to the emergency department (ED) with acute abdominal pain. Initial physical examination, imaging studies, and relevant laboratory findings led to a diagnosis of aortic dissection, with the dissection flap extending into multiple vascular regions (5,6). Prompt recognition and diagnosis are essential in such cases, where early intervention can be life-saving (7). Case Presentation A 51-year-old male with a medical history of hypertension, migraines, and previous hernia repair, with no known drug allergies, presented to the emergency department with severe, sudden-onset abdominal pain. The pain began one hour prior while the patient was going to the bathroom and was described as generalized and non-radiating. He reported no chest pain, nausea, vomiting, or diarrhea, and denied other symptoms such as shortness of breath, headache, blurred vision, or tinnitus. On examination, the patient was conscious and alert, but appeared frightened. His abdomen was rigid and distended, with generalized tenderness. There was no peripheral edema. Vital signs included blood pressure (BP) of 138/78 mmHg, temperature 37°C, respiratory rate 20 breaths per minute, heart rate 80 beats per minute, and oxygen saturation 96%. Laboratory Investigations and Imaging Reports Significant laboratory findings included elevated troponin levels, prompting serial monitoring, while both amylase and lipase were within normal limits. Lactic acid was notably elevated at 3.8 mmol/L, and C-reactive protein (CRP) levels were raised, although the specific value was not available. The renal function tests indicated normal creatinine levels at 0.97 mg/dL, with sodium at 137 mmol/L, potassium at 5.0 mmol/L, and chloride at 112 mmol/L. However, calcium was slightly low at 7.7 mg/dL. Liver function tests showed normal levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), with total bilirubin at 0.97 mg/dL and normal albumin levels. The D-dimer was extremely elevated, raising suspicion for an aortic dissection. The complete blood count (CBC) revealed a hemoglobin level of 82 g/L, indicating anemia, with a hematocrit of 23.8%. The white blood cell (WBC) count was normal at 5210/µL, while the platelet count was 144 x 10^9/L. The mean corpuscular volume (MCV) was 87.5 fL, with a differential showing neutrophils at 84.8%, lymphocytes at 9.6%, and monocytes at 4.4%. A bedside ultrasound was performed using a Philips CX50 ultrasound machine (serial number: SG82305015) revealed an aortic flap, suggestive of a dissection (Figure 1) , which prompted further investigation with computed tomography (CT) angiography. The CT angiography confirmed a type A aortic dissection extending from the aortic valve down to both common iliac arteries. Notable findings included an ectatic ascending aorta measuring approximately 4.4 cm in anterior-posterior diameter, with a dissection flap extending down the aorta (Figure 2 & 3 ). The false lumen was larger than the true lumen, consistent with an advanced dissection. There was suspicion of an intimal tear in the abdominal aorta just below the superior mesenteric artery (SMA), which showed intimal thickening but normal opacification . Both main coronary arteries arose from the true lumen, with no evidence of dissection involving the coronary vessels. The dissection extended into the brachiocephalic artery, with an intramural thrombus compromising the true lumen and extending into the proximal right common carotid artery, raising suspicion of focal thrombosis approximately 6 mm from its origin. The right renal artery arose from the true lumen, while the left renal artery arose from the false lumen, with the left kidney showing signs of reduced perfusion but no evidence of dissection in the left renal artery. Discussion and Conclusions Aortic dissection is a medical emergency, often presenting with tearing chest pain, but this case highlights the importance of considering atypical presentations such as abdominal pain. The patient’s initial presentation, coupled with key laboratory findings such as elevated D-dimer and imaging results indicating a widened mediastinum and an aortic flap (Figure 4 ), quickly led to the correct diagnosis. The extension of the dissection flap into multiple vascular regions, including the brachiocephalic and iliac arteries, increased the complexity of the case. Laboratory results, including elevated lactate and D-dimer, supported the suspicion of tissue ischemia and vascular injury. The low hemoglobin and hematocrit levels raised concerns about potential bleeding, although no significant periaortic leakage was detected on imaging. Early diagnosis of aortic dissection, especially when presenting atypically, requires a high index of suspicion. In this case, bedside ultrasound and CT angiography confirmed the diagnosis, and immediate surgical consultation was sought. Finally, This case emphasizes the critical need for timely diagnosis of aortic dissection in the emergency department, especially in patients presenting with atypical symptoms such as abdominal pain. Abbreviations AAA Abdominal Aortic Aneurysm RSI Rapid sequence intubation US Ultrasound POCUS Point of Care Ultrasonography GCS Glasgow Coma Scale USPSTF United States Preventive Services Task Force Declarations - Ethical approval This study was approved by “Jordan university Institutional review board (IRB), and This study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and Belmont report. - Consent to participate. A written informed consent was obtained from all participants for participation. - Consent to publication. A written informed consent was obtained from the patient legal guardian for the publication of this study and accompanying images. - Availability of data and material All data generated or analyzed during this study are included in this published article. - Competing interests. The authors declare that they have no competing interests. - Funding This study required no funding . - Authors’ contributions: BH and RS worked together in sorting out the data and organizing it from the electronic patient system and writing the manuscript. RA wrote the abstract and had an important role in editing the manuscript. IA took a written consent from the patient legal guardian and edited the manuscript writing with the supervision of the teamwork. - Acknowledgements. Not applicable References Yuan X, Mitsis A, Nienaber CA. Current Understanding of Aortic Dissection. Life (Basel). 2022;12(10):1606. 10.3390/life12101606 . PMID: 36295040; PMCID: PMC9605578. Gouveia E, Melo R, Mourão M, Caldeira D, Alves M, Lopes A, Duarte A, Fernandes E, Fernandes R, Mendes Pedro L. A systematic review and meta-analysis of the incidence of acute aortic dissections in population-based studies. J Vasc Surg. 2022;75(2):709–20. Epub 2021 Sep 22. PMID: 34560218. Sayed A, Munir M, Bahbah EI, Aortic Dissection. A Review of the Pathophysiology, Management and Prospective Advances. Curr Cardiol Rev. 2021;17(4):e230421186875. 10.2174/1573403X16666201014142930 . PMID: 33059568; PMCID: PMC8762162. Gibbons RC, Smith D, Feig R, Mulflur M, Costantino TG. The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study. Acad Emerg Med. 2024;31(2):112–8. 10.1111/acem.14839 . Epub 2023 Dec 19. PMID: 38010071. Wang Y, Yu H, Cao Y, Wan Z. Early Screening for Aortic Dissection With Point-of-Care Ultrasound by Emergency Physicians: A Prospective Pilot Study. J Ultrasound Med. 2020;39(7):1309–15. 10.1002/jum.15223 . Epub 2020 Jan 23. PMID: 31971274. Flachskampf FA, Daniel WG. Aortic Dissection. Cardiol Clin. 2000;18(4):807–17. 10.1016/S0733-8651(05)70181-8 . Gibbons RC, Smith D, Feig R, et al. The SPEED Protocol: Using Ultrasound To Detect Acute Aortic Dissection. Acad Emerg Med. 2024;31(2):112–8. Epub 2024 May 10. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7684568","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":533565672,"identity":"c75058f1-b33b-4949-82ee-dea32c11e7e7","order_by":0,"name":"Ihab 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1","display":"","copyAsset":false,"role":"figure","size":375884,"visible":true,"origin":"","legend":"\u003cp\u003eYellow arrow: Inferior vena cava, Blue arrow: Aorta, Orange arrow: intimal flap\u003c/p\u003e","description":"","filename":"image1.png","url":"https://assets-eu.researchsquare.com/files/rs-7684568/v1/220647cac314296374c17be7.png"},{"id":94398670,"identity":"5618366d-3430-42cd-977d-837c03b0c8c2","added_by":"auto","created_at":"2025-10-27 13:57:10","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":284473,"visible":true,"origin":"","legend":"\u003cp\u003ePurple arrow: dissecting ascending aorta, Blue arrow: Dissecting descending aorta, Circle: True lumen, Rectangle: False lumen\u003c/p\u003e","description":"","filename":"image2.png","url":"https://assets-eu.researchsquare.com/files/rs-7684568/v1/a726fd9d1b0dead4db10e4f1.png"},{"id":94397465,"identity":"f4c63995-c215-41b7-8ebf-05840fe0cbf9","added_by":"auto","created_at":"2025-10-27 13:56:41","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":250827,"visible":true,"origin":"","legend":"\u003cp\u003eGreen arrow: Dissecting Aortic Arch\u003c/p\u003e","description":"","filename":"image3.png","url":"https://assets-eu.researchsquare.com/files/rs-7684568/v1/282095ea4af27a8e3f806f9a.png"},{"id":94398665,"identity":"329fa75a-6b2e-4cbe-a163-ecef51b18926","added_by":"auto","created_at":"2025-10-27 13:57:10","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":340677,"visible":true,"origin":"","legend":"\u003cp\u003ePink arrow: Parasternal long axis displaying the intimal flap within the aorta.\u003c/p\u003e","description":"","filename":"image4.png","url":"https://assets-eu.researchsquare.com/files/rs-7684568/v1/edc695c36618d3049317889d.png"},{"id":102295891,"identity":"23715b5b-1b88-455c-a6c5-aa23f79c908b","added_by":"auto","created_at":"2026-02-10 10:15:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2412539,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7684568/v1/48be9a2c-a3c1-4d0d-9306-6b85b86dda25.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Huge Aortic Dissection Discovered by Point of Care Ultrasonography (POCUS): A Case Report","fulltext":[{"header":"Background","content":"\u003cp\u003eAortic dissection is an emergent medical condition, generally affecting the elderly, characterized by a separation of the aortic wall layers and subsequent creation of a pseudolumen that may compress the true aortic lumen dissection (3,4). Aortic dissection is a life-threatening condition, often presenting with chest pain. However, atypical presentations, including abdominal pain, may occur. We report a case of a 51-year-old male with a known history of hypertension and migraines who presented to the emergency department (ED) with acute abdominal pain. Initial physical examination, imaging studies, and relevant laboratory findings led to a diagnosis of aortic dissection, with the dissection flap extending into multiple vascular regions (5,6). Prompt recognition and diagnosis are essential in such cases, where early intervention can be life-saving (7).\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Case Presentation","content":"\u003cp\u003eA 51-year-old male with a medical history of hypertension, migraines, and previous hernia repair, with no known drug allergies, presented to the emergency department with severe, sudden-onset abdominal pain. The pain began one hour prior while the patient was going to the bathroom and was described as generalized and non-radiating. He reported no chest pain, nausea, vomiting, or diarrhea, and denied other symptoms such as shortness of breath, headache, blurred vision, or tinnitus.\u003c/p\u003e\n\u003cp\u003eOn examination, the patient was conscious and alert, but appeared frightened. His abdomen was rigid and distended, with generalized tenderness. There was no peripheral edema. Vital signs included blood pressure (BP) of 138/78 mmHg, temperature 37°C, respiratory rate 20 breaths per minute, heart rate 80 beats per minute, and oxygen saturation 96%.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLaboratory Investigations and Imaging Reports\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSignificant laboratory findings included elevated troponin levels, prompting serial monitoring, while both amylase and lipase were within normal limits. Lactic acid was notably elevated at 3.8 mmol/L, and C-reactive protein (CRP) levels were raised, although the specific value was not available. The renal function tests indicated normal creatinine levels at 0.97 mg/dL, with sodium at 137 mmol/L, potassium at 5.0 mmol/L, and chloride at 112 mmol/L. However, calcium was slightly low at 7.7 mg/dL. Liver function tests showed normal levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), with total bilirubin at 0.97 mg/dL and normal albumin levels. The D-dimer was extremely elevated, raising suspicion for an aortic dissection. The complete blood count (CBC) revealed a hemoglobin level of 82 g/L, indicating anemia, with a hematocrit of 23.8%. The white blood cell (WBC) count was normal at 5210/µL, while the platelet count was 144 x 10^9/L. The mean corpuscular volume (MCV) was 87.5 fL, with a differential showing neutrophils at 84.8%, lymphocytes at 9.6%, and monocytes at 4.4%.\u003c/p\u003e\n\u003cp\u003eA bedside ultrasound was performed using a \u003cstrong\u003ePhilips CX50 ultrasound machine (serial number: SG82305015)\u0026nbsp;\u003c/strong\u003erevealed an aortic flap, suggestive of a dissection \u003cstrong\u003e(Figure 1)\u003c/strong\u003e, which prompted further investigation with computed tomography (CT) angiography. The CT angiography confirmed a type A aortic dissection extending from the aortic valve down to both common iliac arteries. Notable findings included an ectatic ascending aorta measuring approximately 4.4 cm in anterior-posterior diameter, with a dissection flap extending down the aorta \u003cstrong\u003e(Figure 2 \u0026amp; 3 ).\u003c/strong\u003e The false lumen was larger than the true lumen, consistent with an advanced dissection. There was suspicion of an intimal tear in the abdominal aorta just below the superior mesenteric artery (SMA), which showed intimal thickening but normal opacification\u003cstrong\u003e.\u003c/strong\u003e Both main coronary arteries arose from the true lumen, with no evidence of dissection involving the coronary vessels. The dissection extended into the brachiocephalic artery, with an intramural thrombus compromising the true lumen and extending into the proximal right common carotid artery, raising suspicion of focal thrombosis approximately 6 mm from its origin. The right renal artery arose from the true lumen, while the left renal artery arose from the false lumen, with the left kidney showing signs of reduced perfusion but no evidence of dissection in the left renal artery.\u003c/p\u003e"},{"header":"Discussion and Conclusions","content":"\u003cp\u003eAortic dissection is a medical emergency, often presenting with tearing chest pain, but this case highlights the importance of considering atypical presentations such as abdominal pain. The patient’s initial presentation, coupled with key laboratory findings such as elevated D-dimer and imaging results indicating a widened mediastinum and an aortic flap \u003cstrong\u003e(Figure 4\u003c/strong\u003e), quickly led to the correct diagnosis. The extension of the dissection flap into multiple vascular regions, including the brachiocephalic and iliac arteries, increased the complexity of the case.\u003c/p\u003e\n\u003cp\u003eLaboratory results, including elevated lactate and D-dimer, supported the suspicion of tissue ischemia and vascular injury. The low hemoglobin and hematocrit levels raised concerns about potential bleeding, although no significant periaortic leakage was detected on imaging.\u003c/p\u003e\n\u003cp\u003eEarly diagnosis of aortic dissection, especially when presenting atypically, requires a high index of suspicion. In this case, bedside ultrasound and CT angiography confirmed the diagnosis, and immediate surgical consultation was sought. Finally, This case emphasizes the critical need for timely diagnosis of aortic dissection in the emergency department, especially in patients presenting with atypical symptoms such as abdominal pain.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eAAA\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eAbdominal Aortic Aneurysm\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eRSI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eRapid sequence intubation\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eUS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eUltrasound\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePOCUS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ePoint of Care Ultrasonography\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eGCS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eGlasgow Coma Scale\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eUSPSTF\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eUnited States Preventive Services Task Force\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e- \u003cu\u003eEthical approval\u0026nbsp;\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by “Jordan university Institutional review board (IRB), and\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study was performed in accordance with the ethical standards as laid down in the 1964\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDeclaration of Helsinki and Belmont report.\u003c/p\u003e\n\u003cp\u003e- \u003cu\u003eConsent to participate.\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eA written informed consent was obtained from all participants for participation.\u003c/p\u003e\n\u003cp\u003e- \u003cu\u003eConsent to publication.\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eA written informed consent was obtained from the patient legal guardian for the publication of this study and accompanying images.\u003c/p\u003e\n\u003cp\u003e- \u003cu\u003eAvailability of data and material\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analyzed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e- \u003cu\u003eCompeting interests.\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e- \u003cu\u003eFunding\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eThis study required no funding\u003c/u\u003e\u003cu\u003e.\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003e- \u003cu\u003eAuthors’ contributions:\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eBH and RS worked together in sorting out the data and organizing it from the electronic patient system and writing the manuscript. RA wrote the abstract and had an important role in editing the manuscript. IA took a written consent from the patient legal guardian and edited the manuscript writing with the supervision of the teamwork.\u003c/p\u003e\n\u003cp\u003e-\u0026nbsp; \u0026nbsp;\u0026nbsp;Acknowledgements.\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eYuan X, Mitsis A, Nienaber CA. Current Understanding of Aortic Dissection. Life (Basel). 2022;12(10):1606. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/life12101606\u003c/span\u003e\u003cspan address=\"10.3390/life12101606\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 36295040; PMCID: PMC9605578.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGouveia E, Melo R, Mour\u0026atilde;o M, Caldeira D, Alves M, Lopes A, Duarte A, Fernandes E, Fernandes R, Mendes Pedro L. A systematic review and meta-analysis of the incidence of acute aortic dissections in population-based studies. J Vasc Surg. 2022;75(2):709\u0026ndash;20. Epub 2021 Sep 22. PMID: 34560218.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSayed A, Munir M, Bahbah EI, Aortic Dissection. A Review of the Pathophysiology, Management and Prospective Advances. Curr Cardiol Rev. 2021;17(4):e230421186875. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2174/1573403X16666201014142930\u003c/span\u003e\u003cspan address=\"10.2174/1573403X16666201014142930\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 33059568; PMCID: PMC8762162.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGibbons RC, Smith D, Feig R, Mulflur M, Costantino TG. The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study. Acad Emerg Med. 2024;31(2):112\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/acem.14839\u003c/span\u003e\u003cspan address=\"10.1111/acem.14839\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2023 Dec 19. PMID: 38010071.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWang Y, Yu H, Cao Y, Wan Z. Early Screening for Aortic Dissection With Point-of-Care Ultrasound by Emergency Physicians: A Prospective Pilot Study. J Ultrasound Med. 2020;39(7):1309\u0026ndash;15. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1002/jum.15223\u003c/span\u003e\u003cspan address=\"10.1002/jum.15223\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2020 Jan 23. PMID: 31971274.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFlachskampf FA, Daniel WG. Aortic Dissection. Cardiol Clin. 2000;18(4):807\u0026ndash;17. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/S0733-8651(05)70181-8\u003c/span\u003e\u003cspan address=\"10.1016/S0733-8651(05)70181-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGibbons RC, Smith D, Feig R, et al. The SPEED Protocol: Using Ultrasound To Detect Acute Aortic Dissection. Acad Emerg Med. 2024;31(2):112\u0026ndash;8. Epub 2024 May 10.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"POCUS, Point-of-care ultrasound, Aortic dissection","lastPublishedDoi":"10.21203/rs.3.rs-7684568/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7684568/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe aorta is the body’s largest blood vessel, and its primary function is to carry oxygen and blood from the left ventricle to other body organs. Anatomically, the aorta is divided into four parts: the ascending aorta, the aortic arch, the descending thoracic aorta, and finally, the abdominal aorta (1). The worldwide incidence rate estimate of Acute aortic dissection (AAD) was found to be 4.8 per 100,000 individuals/year (2). Aortic dissection is a life-threatening condition, often presenting with chest pain. However, atypical presentations, including abdominal pain, may occur. In this case report of a 51-year-old male patient, we will show the important role of using Point of care ultrasonography (POCUS) as a part of clinical examination in unstable patients with atypical presentations in the Emergency department.\u003c/p\u003e","manuscriptTitle":"Huge Aortic Dissection Discovered by Point of Care Ultrasonography (POCUS): A Case Report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-26 01:20:39","doi":"10.21203/rs.3.rs-7684568/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"634f2898-502a-4f11-81e2-dcacf58859d5","owner":[],"postedDate":"October 26th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-01T17:54:44+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-26 01:20:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7684568","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7684568","identity":"rs-7684568","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}