Type B Aortic Dissection in a Young Patient with Methamphetamine Use: A Case Report

We report an uncommon case of Stanford type B aortic dissection in a young woman with recent methamphetamine use and no comorbidities. This case illustrates an atypical presentation of a high-mortality condition and highlights an under-recognized association in the literature. The patient presented to the emergency department with sudden-onset chest pain radiating to the back, associated with dyspnea following methamphetamine use. Physical examination revealed bradycardia and hypoxemia without additional abnormalities. Dyspnea of possible thromboembolic origin was evaluated with chest CT angiography, which incidentally demonstrated a Stanford type B dissection without significant aortic dilation. This case underscores the need to maintain a high index of suspicion for aortic dissection in young patients using sympathomimetic drugs, even in the absence of aortic dilation. Methamphetamine may induce vascular changes that predispose to aortic dissection at smaller-than-expected diameters, challenging traditional diagnostic paradigms.