Thrombosed Type B Aortic Dissection: An Uncomplicated Appearance with a Fatal Outcome

Aortic dissection remains a critical cardiovascular emergency with high mortality. We present the case of a 68-year-old male, a chronic smoker without known hypertension, who arrived with sudden back and lumbar pain. Initial examination showed stable vital signs and no neurological abnormalities. Transthoracic echocardiography identified a double aortic wall, raising suspicion for a thrombosed false lumen. Subsequent CT angiography confirmed a type B aortic dissection with a thrombosed lumen, spanning from the thoracic to the suprarenal abdominal aorta. Medical management using beta-blockers and ACE inhibitors was initiated. Despite apparent initial stability, the patient suffered a sudden cardiac death. This case underscores the unpredictable nature and potential severity of type B aortic dissections, even in the absence of classic risk factors.