Masturbation-Induced Presyncope: A Case of Painless Aortic Dissection in IgG4-Related Disease.

This case concerns a 59-year-old male with a past medical history of hypertension, chronic renal insufficiency, and autoimmune pancreatitis secondary to IgG4-related disease, on chronic steroids. The patient experienced acute onset of lightheadedness, a tingling sensation to both hands, and jaw tightness while masturbating. He was found to have a Type A aortic dissection. This is the first case of its kind to document an atypical, painless aortic dissection presentation in a patient with IgG4-related disease. This piece explores how fibroinflammatory sequelae of IgG4-related disease can result in aortic manifestations and discusses the importance of considering a broader differential including aortic syndrome when encountering patients presenting with atypical symptoms.