Background: Aortic dissection is a dangerous condition with a high mortality in the acute stage. Aortic dissectionrequires early diagnosis and treatment.Methods and Results: This short review discusses and focuses on known complications of aortic dissection andits natural mortality applying data from already published reports and from cohorts and registers, especially IRAD.Survival data of patients with type A and type B of dissection are presented and treatment options are proposed. Thereview presents three interesting cases from our database pointing out mistakes made in the diagnostic process and indealing with the patient even after establishing the correct diagnosis. In one case, a patient with chest pain + “immeasurable”BP was suspected to suff er from an acute myocardial infarction and cardiogenic shock instead of AoD + aorticbranch obstruction. In another patient with chest pain + V1V2 ST elevation, again the acute coronary syndrome wassuspected. In fact, AoD with a perforation to cardiac chambers through the interventricular septum was the explanation.In the third case, the correct diagnosis of AoD was established. This patient was at a signifi cant risk of aortic rupturebecause of his uncontrolled blood pressure. Instead of sedation administration and eff ective BP lowering, the patientwas stressed even more by detailed information about this life threatening disease. This led to an aortic rupture withcardiac tamponade. Other mistakes made when dealing with all these presented cases are also discussed.Conclusion: The high mortality in patients suff ering from aortic dissection is often potentiated by misdiagnosingand mishandling of these patients in clinical scenario.

Department of Internal Medicine University Hospital Olomouc

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