Delayed asymptomatic progressive aortic dissecting aneurysm in patient with STEMI

Aortic dissection is relatively uncommon occurring at about 3 cases per 100,000 per year. Most of inciting event in aortic dissection is intimal tearing. The dissection propagates antegrade or retrograde manner due blood flow, which responsible for clinical manifestations such as tamponade, aortic valve insufficiency, coronary artery involvement. Risk factors are hypertension, smoking, trauma, connective tissue disorders, vasculitis and other iatrogenic events. Most frequent presentation is sudden onset severe chest pain or back pain. However, some patients present with painless or variety of symptoms and manifestations such as myocardial infarction, aortic regurgitation, intrathoracic hemorrhage and fever of unknown origin (FUO), resulting in a delayed diagnosis. The Diagnosis of aortic dissection depends upon demonstration on imaging studies include computed tomography, echocardiography, magnetic resonance imaging. They identify the extent of aortic involvement, entry and reentry sites, aortic insufficiency, coronary artery involvement, pericardial or mediastinal hemorrhage as well. We presented a case of delayed progressed asymptomatic aortic dissection in patient with STEMI.