Aortic dissection presenting as left leg numbness and paralysis

We present the case of a 46-year-old man with a Stanford A aortic dissection presenting as left leg numbness and paralysis. There were few indications of dissection on history and physical examination, and the patient was initially seen by an orthopedist for an acute radiculopathy. A complaint of mild chest pain was elicited on repeated questioning and eventually led to the correct diagnosis. The patient underwent extensive stenting and revascularization intraoperatively and was eventually transferred from the intensive care unit to the ward. This case highlights the need for a high level of suspicion required to diagnose aortic dissection and the atypical and painless manner in which a small proportion of aortic dissections can present.