Death due to extensive aortic dissection with an unusual retrograde extension in a young adult. (November 2022)

• Record Type: Journal Article
• Authors: Bhowmik, Sourav; Jadav, Devendra; Tak, Manish; Meshram, Vikas; Khera, Sudeep; Sharma, Rashim; Kanchan, Tanuj
• Is Part Of: Journal of forensic and legal medicine. Volume 92(2022)
• Publication Date: 2022-11
• Subjects: Sudden death -- Stanford 'type A' aortic dissection -- Young adult -- Autopsy -- Brachiocephalic artery -- Left common carotid artery; Medical jurisprudence -- Periodicals; Forensic sciences -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Electronic journals; 614.1
• DOI: 10.1016/j.jflm.2022.102437
• Languages: English
• ISSNs: 1752-928X

Abstract

Abstract: Aortic dissection usually manifests in older individuals. It is a rare cause of sudden death in the age group <35 years. Compared to older age groups, this age range is likely to have distinct clinical and pathologic features, uncommon risk factors, and an unusual presentation. This case reports the sudden death of a 34-year-old male due to extensive aortic dissection without any previously known predisposing factors. Autopsy examination showed the presence of aortic dissection with the formation of the false lumen, which extended from the root of the aorta to the whole length of the ascending aorta, arch of the aorta and further up to 27 cm length of the descending aorta. The pathological examination also revealed retrograde involvement of the brachiocephalic artery and left common carotid artery. The reported AD belonged to Stanford 'type A'. Such extensive AD with unique retrograde extension is rarely reported in Forensic Pathology literature. Highlights: Aortic dissection is an unusual cause of sudden death in the young adults. Rarely, the aortic dissection can involve the entire length of aorta. The present case reports the retrograde involvement of the brachiocephalic artery and left common carotid artery along with involvement of almost entire length of aorta. Medicolegal issues can arise in cases of sudden death due to Aortic dissection when the doctor misses the clinical diagnosis.