Acute Aortic Dissection Presenting as Left Upper Limb Ischemia: Report of Two Cases of DeBakey Type I Dissection

Acute upper limb ischemia is most frequently the result of an embolus that originates in the heart. Ascending aortic dissection is a life-threatening vascular emergency that must be treated immediately. Isolated upper limb ischemia secondary to acute aortic dissection has not been previously reported. Two cases of DeBakey type I aortic dissection presenting as unilateral upper limb ischemia are reported. This presentation may result in delayed diagnosis of aortic dissection and, consequently, in high mortality. The possibility should be borne in mind when dealing with all cases of acute arm ischemia because embarking on a brachial embolectomy which may delay the diagnosis of a more serious and fatal condition. The etiology of this unusual presentation and possible therapeutic interventions are discussed.