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The close anatomical relationship suggests direct mechanical compression and disturbed local hemodynamics contributed to thrombus formation, highlighting the need for early diagnosis and tailored therapy.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/simultaneous-aortic-dissection-and-saddle-pulmonary-embolism-were-they-intertwined/419106/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/simultaneous-aortic-dissection-and-saddle-pulmonary-embolism-were-they-intertwined/419106.png","ImageObject",300,407,{"name":42,"@type":43},"Aditya","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What condition caused the patient’s sudden paraplegia?","Question",{"text":63,"@type":64},"MRI of the dorsal spine showed extensive spinal cord infarction.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What vascular abnormalities were found on subsequent imaging?",{"text":68,"@type":64},"A Stanford type B aortic dissection with false-lumen thrombosis and a coexistent saddle pulmonary embolism were identified.",{"name":70,"@type":61,"acceptedAnswer":71},"Why might the aortic dissection have contributed to the pulmonary embolism?",{"text":72,"@type":64},"The report suggests their close anatomical relationship may have allowed direct mechanical compression and disturbed local hemodynamics that promoted pulmonary thrombus formation.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},419106,1790620414,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":107,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},962085564549,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Review began 11/10/2025  \nReview ended 11/27/2025  \nPublished 12/03/2025  \n© Copyright 2025  \nAmaral de Vasconcelos Pinheiro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98377  \nOpen Access Case Report  \nSimultaneous Aortic Dissection and Saddle Pulmonary Embolism: Were They Intertwined?  \nMiguel João Amaral de Vasconcelos Pinheiro 1 , Tiago Serrano Constantino 2, João Fonseca Oliveira 3, 4, Ana Maria Cordeiro 5, Sofia Pinheiro 6  \n1. Internal Medicine, Hospital São José, Hospital Santo António dos Capuchos, Lisbon, PRT 2. Cardiology Service, Hospital Santa Marta, Lisbon, PRT 3. Internal Medicine, Centro Hospitalar Universitário de Lisboa Central, Lisbon, PRT  \n4. Internal Medicine, Nova Medical School, Lisbon, PRT 5. Radiology, Hospital Santo António dos Capuchos, Centro Hospitalar Universitário Lisboa Central, Lisbon, PRT 6. Medicine Service, Hospital Santo António dos Capuchos, Lisbon, PRT  \nCorresponding author: Miguel João Amaral de Vasconcelos Pinheiro, [migueljavpinheiro@gmx.com](migueljavpinheiro@gmx.com)  \nAbstract  \nWe report the case of a 92-year-old woman who developed sudden paraplegia. A magnetic resonance imaging (MRI) of the dorsal spine revealed extensive spinal cord infarction. Subsequent imaging demonstrated a Stanford type B aortic dissection complicated by false-lumen thrombosis, along with acoexistent saddle pulmonary embolism. Although the coexistence of pulmonary embolism and aortic dissection has been reported, it remains poorly understood and represents a major therapeutic challenge. In this case, the close anatomical relationship between the descending aortic dissection and the site of pulmonary artery thrombosis strongly suggests that the aortic dissection may have contributed to pulmonary thrombus formation through direct mechanical compression and disturbed local hemodynamics arising from their anatomical contiguity. This case illustrates a rare yet clinically significant overlap between two life-threatening vascular entities, suggesting a poorly characterized pathophysiological interplay and underscoring the need for early diagnosis and patient-specific therapeutic approaches.  \nCategories: Emergency Medicine, Internal Medicine, Cardiac/Thoracic/Vascular Surgery  \nKeywords: aortic thrombosis, complications of aortic dissection, medular infarct, saddle pulmonary embolism,  \nstanford type b dissection, symptoms of aortic dissection, therapeutic anticoagulation  \nIntroduction  \nAcute aortic dissection is a life-threatening medical emergency with a high mortality rate. It occurs when an injury to the innermost layer of the aortic wall allows blood to enter and separate the layers of the vessel.  \nThe major risk factors include hypertension, connective tissue disorders, a congenitally bicuspid aortic valve, and aortic coarctation [1,2] .  \nPatients with aortic dissection may present with a broad spectrum of symptoms; therefore, diagnosis requires a high index of clinical suspicion. Chest pain is the most frequent presenting symptom, but pulse deficits or a new aortic regurgitation murmur may also be observed. Anterior chest pain is more typical in dissections involving the ascending aorta, whereas back or abdominal pain predominates in dissections of the descending aorta [2] .  \nThe Stanford classification of aortic dissections is clinically useful, as it aligns with therapeutic  \nstrategies: type A dissections, involving the ascending aorta, generally require urgent surgical repair, whereas type B dissections, characterized by an intimal tear originating distal to the left subclavian artery, are usually managed medically [3] . Nonetheless, in Stanford type B aortic dissection, patients who are hemodynamically unstable or present with critical organ malperfusion generall","cbCaidkGEJTQ5SKg","https://ap.wps.com/l/cbCaidkGEJTQ5SKg","pdf",3464911,"English","# Abstract\n# Introduction\n## Acute aortic dissection overview\n## Stanford classification and management\n## Pathophysiology: spinal ischemia and false-lumen thrombosis\n## Pulmonary embolism overview and rarity of coexistence\n# How to cite","[{\"question\":\"What condition caused the patient’s sudden paraplegia?\",\"answer\":\"MRI of the dorsal spine showed extensive spinal cord infarction.\"},{\"question\":\"What vascular abnormalities were found on subsequent imaging?\",\"answer\":\"A Stanford type B aortic dissection with false-lumen thrombosis and a coexistent saddle pulmonary embolism were identified.\"},{\"question\":\"Why might the aortic dissection have contributed to the pulmonary embolism?\",\"answer\":\"The report suggests their close anatomical relationship may have allowed direct mechanical compression and disturbed local hemodynamics that promoted pulmonary thrombus formation.\"}]","Simultaneous Aortic Dissection and Saddle Pulmonary Embolism - Were They Intertwined | PDF",1790615642,18]