Misdiagnosing aortic dissection: A fatal mistake

Dixon, Maria A.

doi:10.1016/j.jvn.2011.08.003

Cited by 5 publications

(12 citation statements)

References 32 publications

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“…This raises concerns about the appropriate education of EMS staff when it comes to recognizing aortic dissection in the prehospital setting. The need for education has also been highlighted by Dixon 3 …”

Section: Discussionmentioning

confidence: 99%

“…However, the blood pressure was not very high, so there only appeared to be clear indications for anti-hypertensive treatment in a minority of the patients. Finally, many patients (20%) received anti-thrombotic treatment, which can be detrimental in aortic dissection 3 5 , 25 …”

Section: Discussionmentioning

confidence: 99%

“…The highest mortality was reported in Stanford Type A, particularly if patients were not operated on (58%) 5 . A Stanford Type B dissection (involving the descending aorta or the arch, without the involvement of the ascending aorta) has been reported to have a lower mortality rate, and these patients do not generally undergo surgery 3 5 - 8 However, in subjects who develop ischemic complications or a contained rupture, requiring urgent surgical or endovascular repair, 30-day mortality approaches 25% 2 …”

Section: Introductionmentioning

confidence: 99%

“…Due to the variety of symptoms, and the fact that acute myocardial infarction is much more common than aortic dissection, these patients are often misinterpreted as having an acute myocardial infarction 12 13 A misinterpretation of this kind might be detrimental, as anti-thrombotic treatment is not the drug of choice in aortic dissection and might, in fact, modify the progression of the disease in an unfavorable fashion 3 5 …”

Section: Introductionmentioning

confidence: 99%

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A Description of the Prehospital Phase of Aortic Dissection in Terms of Early Suspicion and Treatment

Axelsson

Karlsson

Pande

et al. 2015

Prehosp. Disaster med.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Description of the Prehospital Phase of Aortic Dissection in Terms of Early Suspicion and Treatment

Axelsson

Karlsson

Pande

et al. 2015

Prehosp. Disaster med.

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show abstract

“…The occurrence of aortic dissection is usually preceded by diseases that have weakened the aortic wall. Medial degeneration tends to be more extensive in older adults with chronic hypertension, in cystic medial necrosis associated connective tissue disorders such as Marfan's syndrome and with atherosclerosis causing occlusion and injury of the vasa vasorum [4].…”

Section: Introductionmentioning

confidence: 99%

Atypical Clinical Presentation of Extensive Aortic Dissection at Mulago Hospital: Case Report

St¹,

Rwebembera²,

Ab³

et al. 2018

J Thrombo Cir

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Acute aortic dissection (AD) has a high morbidity and mortality rates, 1% to 2% of patients with aortic dissection die per hour for the first 24-48 hours after their admission in the hospital. Medical imaging plays a big role in the diagnosis of AD and treatment plan. The present case is a fifty-four year old male admitted at Mulago Hospital in Uganda with sudden onset chest pains, became unconscious for few minutes then recovered the consciousness with ability to walk, stand and sit. Clinical diagnosis prior to radiological investigation was acute coronary syndrome. Surprisingly cardiac Echo showed AD with aortic regurgitation. Computed tomography aortogram showed aortic dissection De Bakey type I. The immediate medical management included intravenous morphine and an oral beta blocker, with a target of maintaining the systolic blood pressure <100 mmHg and the resting heart rate between 60-70 bpm. The patient was discharged from the hospital after eleven days on medical therapy including oral bisoprolol, oral losartan and furosemide. Arrangements for Bentall procedure and Thoracic Endovascular Aortic Repair (TEVAR) were planned in two months at the time of discharge from hospital; unfortunately the patient has never been operated. He has been maintained on medical therapy for three years. The aim of this clinical report is to appreciate the role of radiological investigations in the diagnosis of atypical clinical presentation of extensive aortic dissection.

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Three cases of diagnostic delay of type A acute aortic dissection

Shimamoto,

Tomotsuka,

Takehara

et al. 2024

Egypt Heart J

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Background Diagnostic delay (DD) can be lethal when patients with type A acute aortic dissection (TAAAD). We report 3 cases of DD associated with TAAAD. Case presentation Case 1 is a female in her sixties presenting with severe back pain. A CT scan was taken, and TAAAD with a thrombosed false lumen was suspected by the radiology technician. He did not successfully transfer his concern to the physicians and the patient was sent home. The next day, she was transferred to another hospital with a recurrence of the symptom, and the diagnosis of TAAAD was made with a CT scan there. Case 2 was an 87-year-old female who was transferred to our hospital because of a loss of consciousness and bruises on the forehead. CT scan was taken and the displaced intimal flap in her aortic arch was overlooked by the part-time physician almost at the end of his shift. The diagnosis of TAAAD was made by the radiologist. Case 3 was the 44-year-old male who did not have health insurance and experienced severe back pain a few days before the visit to our clinic. On that day, he went to the nearby hospital’s emergency room, and only pain medication was prescribed. A few days later, a CT scan was taken at our hospital to investigate the cause of pyuria and the diagnosis of TAAAD was made. Conclusion DD may be common and multifactorial in our practice. Physicians need to take every step to improve diagnostic accuracy.

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Misdiagnosing aortic dissection: A fatal mistake

Cited by 5 publications

References 32 publications

A Description of the Prehospital Phase of Aortic Dissection in Terms of Early Suspicion and Treatment

A Description of the Prehospital Phase of Aortic Dissection in Terms of Early Suspicion and Treatment

Atypical Clinical Presentation of Extensive Aortic Dissection at Mulago Hospital: Case Report

Three cases of diagnostic delay of type A acute aortic dissection

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