Case Report

Acute Decompensated Heart Failure (ADHF) with aortic dissection Stanford A in middle aged man: a case report

Anbiya Khairul Umam, Ida Bagus Wisnu Widiarta, Marwa Humaira Intizam, Aizar Vesa Prasetyo, Ketut Putu Yasa

Anbiya Khairul Umam
Bachelor of Medicine, Faculty of Medicine, Universitas Udayana, Bali

Ida Bagus Wisnu Widiarta
Bachelor of Medicine, Faculty of Medicine, Universitas Udayana, Bali

Marwa Humaira Intizam
Undergraduate Student, Faculty of Medicine, Universitas Udayana, Bali

Aizar Vesa Prasetyo
Undergraduate Student, Faculty of Medicine, Universitas Udayana, Bali

Ketut Putu Yasa
Cardiovascular and Thoracic Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali. Email:
Online First: July 17, 2021 | Cite this Article
Umam, A., Widiarta, I., Intizam, M., Prasetyo, A., Yasa, K. 2021. Acute Decompensated Heart Failure (ADHF) with aortic dissection Stanford A in middle aged man: a case report. Intisari Sains Medis 12(2): 489-493. DOI:10.15562/ism.v12i2.930

Background: Heart failure is a clinical syndrome with shortness of breath, fluid retention, and the heart's structural and functional disorder. Each year, there were 7,2 cases every 1000 people on male and 4,7 cases every 1000 people on the female. Aortic dissection is an emergency disease in which the symptoms are similar to ischemic heart disease, that 38% of patients got misdiagnosed on the first evaluations. Because of the clinical course of heart failure and misdiagnosed aortic dissection that frequently happened, authors are interested in making a case report with both conditions.

Case report: A male patient, 39 years old, complained of shortness of breath and epigastrium pain. The patient was diagnosed with Acute Decompensated Heart Failure (ADHF) profile B with emergency hypertension and suspected aortic dissection based on history and physical examination. The patient was also diagnosed with acute kidney injury stage 1. CT angiography showed widening of the aorta ascending until arcus aorta with a Stanford type A aortic dissection diagnosis.

Conclusion: The condition of aortic dissection can coincide with acute heart failure. Therefore, a clinician must be aware of the emergency of dissection and know the initial symptoms of dissection. The typical clinical symptoms of dissection lead us to perform imaging studies that ultimately lead to a thoracoabdominal CTA to diagnose the dissection.


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