Authors :
Walther H. Parra; Juan S. Clavijo; Juan S. Vargas; Hollman E. Parada; Asly J. Lizarazo; Alejandro Aponte R.
Volume/Issue :
Volume 10 - 2025, Issue 9 - September
Google Scholar :
https://tinyurl.com/55wsybja
Scribd :
https://tinyurl.com/43mw235f
DOI :
https://doi.org/10.38124/ijisrt/25sep018
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Note : Google Scholar may take 30 to 40 days to display the article.
Abstract :
We report an uncommon case of Stanford type B aortic dissection in a young woman with recent
methamphetamine use and no comorbidities. This case illustrates an atypical presentation of a high-mortality condition and
highlights an under-recognized association in the literature. The patient presented to the emergency department with
sudden-onset chest pain radiating to the back, associated with dyspnea following methamphetamine use. Physical
examination revealed bradycardia and hypoxemia without additional abnormalities. Dyspnea of possible thromboembolic
origin was evaluated with chest CT angiography, which incidentally demonstrated a Stanford type B dissection without
significant aortic dilation. This case underscores the need to maintain a high index of suspicion for aortic dissection in young
patients using sympathomimetic drugs, even in the absence of aortic dilation. Methamphetamine may induce vascular
changes that predispose to aortic dissection at smaller-than-expected diameters, challenging traditional diagnostic
paradigms.
Keywords :
Aortic Dissection; Methamphetamine; Aorta, Thoracic; Emergency Service, Hospital; Cardiovascular Diseases.
References :
- Westover AN, Nakonezny PA. Aortic dissection in young adults who abuse amphetamines. Am Heart J. 2010;160(2):315-321.
- Wako E, LeDoux D, Mitsumori L, Aldea GS. The Emerging Epidemic of Methamphetamine-Induced Aortic Dissections. J Card Surg. 2007;22:390-393.
- Barton M, Wang H. An Uncommon Presentation of Acute Thoracic Aortic Dissection. J Clin Med Res. 2023;15(6):332-335.
- Winslow F, Hansen NS, Jensen MB. Vertebral Artery Dissection Related to Amphetamine Abuse. J Cent Nerv Syst Dis. 2020;2:1179573520939340.
- Luo B-Y, Zhou J, Guo D, et al. Methamphetamine induces thoracic aortic aneurysm/dissection through C/EBPβ. BBA Mol Basis Dis. 2022;1868(6):166447.
- Evangelista A, Isselbacher EM, Bossone E, et al. Insights from the International Registry of Acute Aortic Dissection: a 20-year experience. Circulation. 2018;137(17):1846-1860.
- Akasaki Y, Ohishi M. Cerebrovascular and cardiovascular diseases caused by drugs of abuse. Hypertens Res [Internet]. 2020;43(5):363–71.
- Pape LA, Tsai TT, Isselbacher EM, et al. Aortic diameter >5.5 cm is not a good predictor of type A aortic dissection. Circulation. 2007;116(10):1120-1127.
- Coady MA, Rizzo JA, Hammond GL, et al. Surgical intervention criteria for thoracic aortic aneurysms. Ann Thorac Surg. 1999;67(6):1922-1926.
- Pacini D, Di Marco L, Fortuna D, et al. Acute aortic dissection: epidemiology and outcomes. Int J Cardiol. 2013;167(6):2806-28
We report an uncommon case of Stanford type B aortic dissection in a young woman with recent
methamphetamine use and no comorbidities. This case illustrates an atypical presentation of a high-mortality condition and
highlights an under-recognized association in the literature. The patient presented to the emergency department with
sudden-onset chest pain radiating to the back, associated with dyspnea following methamphetamine use. Physical
examination revealed bradycardia and hypoxemia without additional abnormalities. Dyspnea of possible thromboembolic
origin was evaluated with chest CT angiography, which incidentally demonstrated a Stanford type B dissection without
significant aortic dilation. This case underscores the need to maintain a high index of suspicion for aortic dissection in young
patients using sympathomimetic drugs, even in the absence of aortic dilation. Methamphetamine may induce vascular
changes that predispose to aortic dissection at smaller-than-expected diameters, challenging traditional diagnostic
paradigms.
Keywords :
Aortic Dissection; Methamphetamine; Aorta, Thoracic; Emergency Service, Hospital; Cardiovascular Diseases.