Acute aortic dissection presenting as left upper limb ischemia - Report oftwo 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 is chemia secondary to acute aortic dissection has not been previously reporte d. Two cases of DeBakey type I aortic dissection presenting as unilateral uppe r limb ischemia are reported. This presentation may result in delayed diagn osis of aortic dissection and, consequently, in high mortality. The possibi lity should be borne in mind when dealing with all cases of acute arm ische mia because embarking on a brachial embolectomy which may delay the diagnos is of a more serious and fatal condition. The etiology of this unusual pres entation and possible therapeutic interventions are discussed.