A useful exercise test for detecting leg malperfusion due to aortic dissection.

We herein report a case of leg malperfusion caused by dynamic obstruction after aortic dissection diagnosed by the exercise ankle brachial pressure index test that could not be diagnosed solely by examining the symptoms and investigations at rest. This case suggests that exercise can be a key factor in the diagnosis of this complication. Furthermore, blood pressure elevation can be an exacerbating factor in dynamic obstruction. We recommend conducting an aggressive evaluation of the symptoms and medical examinations not only at rest but also under stress. <Learning objective: Leg malperfusion caused by dynamic obstruction after aortic dissection should not be ruled out even if symptoms and medical examinations are not marked at rest. Exercise ankle brachial pressure index test can be helpful to detect this complication.>.