Acute Aortic Dissection in Monozygotic Twins Presenting Within Days: A Case Report

Acute aortic dissection is a serious cardiovascular emergency that needs immediate attention. It is rare for aortic dissection to occur in twins, and there has been no prior report of it happening in a monozygotic twin within three days. We present the case of a 30-year-old man who presented to the emergency department after an episode of near syncope and was found to have concomitant aortic dissection with inferior myocardial infarction. This case is notable because the patient's twin brother had a repair of Stanford type A aortic dissection just three days prior. The patient underwent an emergent ascending aortic graft and coronary artery bypass graft surgery and recovered after a complex postoperative course. To the best of our knowledge, this is a rare case report of aortic dissection in a pair of twins that occurred within a three-day span, raising a special interest in a timed genetic mechanism for this occurrence. Additionally, this case highlights the importance of maintaining high suspicion of aortic dissection in the appropriate clinical context and in patients with a relevant family history.