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Type A Aortic Dissection Complicated by Renal and Lower Extremity Malperfusion

Gargotta, Hillary R., MSN, FNP-C

Section Editor(s): Jordan, Kathleen S. DNP, RN, FNP-C, ENP-C, SANE-P, FAEN; Column Editor

Advanced Emergency Nursing Journal: January/March 2019 - Volume 41 - Issue 1 - p 23–32
doi: 10.1097/TME.0000000000000220

Acute aortic dissection is a life-threatening condition with the potential for serious complications such as myocardial infarction, heart failure, stroke, paraplegia, renal failure, mesenteric ischemia, and limb ischemia. Emergency department clinicians must be aware of the potential ischemic complications of aortic dissection and act quickly to prevent irreversible organ damage and death. This article highlights a case of a 49-year-old man who developed renal and lower extremity malperfusion secondary to Stanford Type A aortic dissection. Important historical clues and objective findings characteristic of acute aortic dissection and end-organ ischemia are discussed with the purpose of increasing reader knowledge of aortic dissection and signs of organ malperfusion with the hope that better awareness results in improved patient outcomes.

Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas.

Corresponding Author: Hillary R. Gargotta, MSN, FNP-C, Department of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, TX 75390 (

The views expressed in this article are the sole responsibility of the author and do not reflect the views of The University of Texas Southwestern Medical Center or its affiliates.

Disclosure: The author reports no conflicts of interest.

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