Association of Painless Acute Aortic Dissection With Increased Mortality

Park, Seung Woo; Hutchison, Stuart J.; Mehta, Rajendra H.; Isselbacher, Eric M.; Cooper, Jeanna V.; Fang, Jianming; Evangelista, Arturo; Llovet, Alfredo; Nienaber, Christoph; Suzuki, Toru; Pape, Linda; Eagle, Kim A.; Oh, Jae K.

doi:10.4065/79.10.1252

Cited by 181 publications

(169 citation statements)

References 21 publications

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“…60 Although most patients present with these symptoms, some may have a non-specific presentation or even no symptoms, which can delay the diagnosis. 68,69 For that reason, physicians must be familiar with an atypical presentation and a low threshold for diagnostic imaging should be maintained.…”

Section: Level Of Evidence Class Recommenda On 11mentioning

confidence: 99%

Editor's Choice – Management of Descending Thoracic Aorta Diseases

Riambau¹,

Böckler²,

Brunkwall³

et al. 2017

European Journal of Vascular and Endovascular Surgery

919

259

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Section: Level Of Evidence Class Recommenda On 11mentioning

confidence: 99%

Editor's Choice – Management of Descending Thoracic Aorta Diseases

Riambau¹,

Böckler²,

Brunkwall³

et al. 2017

European Journal of Vascular and Endovascular Surgery

919

259

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“…Ancak olguların % 10'unda ağrı görülmemektedir (7). Yapılan çalışmalarda aort diseksiyonu olguları anksiyete, senkop, hipertansiyon, hemiparezi, hemipleji, parapleji, monopleji, disfaji, ayak ağrısı, bacak ağrısı ve baş ağrısı gibi atipik yakınmalarla da karşımıza çıkabilmektedir (14)(15)(16)(17)(18).…”

Section: Discussionunclassified

“…Etiyolojisinde hipertansiyon, ateroskleroz, Marfan ve Ehler Danlos gibi hastalıklar yer almaktadır (5,6). Amerika Birleşik Devletleri'nde insidansı yılda milyonda 5-30 olgu arasında değişmektedir (7). Aort diseksiyonlarında Stanford ve De Bakey olmak üzere iki farklı anatomik sınıflandırma yapılmıştır.…”

Section: Introductionunclassified

Dissekan Aort Anevrizması Rüptürüne Bağlı Ani Ölüm Olgusu

İlhan¹,

Beyaztaş²,

Bütün³

et al. 2014

Bull Leg Med

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ÖZETAort diseksiyonu aortanın en sık rastlanan ölümcül hastalığı olup, acil tanı ve tedavi gerektirmektedir. Ani başlayan ve yırtıcı vasıftaki göğüs ağrısı ile karakterize olan aort diseksiyonu tanısında en önemli basamak klinik şüphedir. Özellikle atipik yakınmalarla başvuran olgularda tanı koymak oldukça güçtür. Hastalığın mortalitesi, tedavi edilmediği takdirde her saat % 1-2 oranında artmaktadır. Bu çalışmada; bulantı ve kusma gibi atipik yakınmalarla acile başvuran, elli iki yaşında bir kadın olgu sunumu yapılmıştır. Olgu sadece bulantı ve kusma şikayetleri ile acil servise başvurmuş, yapılan muayene ve tetkik sonucunda kardiyak patoloji bulunmadığı belirtilmiştir. Altı saat sonra genel durumu bozulmuş ve ölmüştür. Yapılan otopside; perikart ön yüzde iki adet rüptüre alan olduğu, çıkan aortada tespit edilen rüptüre alandan aort köküne doğru 8.5 cm uzunluğunda diseksiyon olduğu, ölüm nedeninin disekan aort anevrizma rüptürü olduğu saptanmıştır. Aort diseksiyonu tanısındaki gecikmeler ölüme yol açabileceği gibi hekimleri de önemli adli sorunlarla karşı karşıya bırakabilecektir. Ayrıca tanının erken konulması ile beklenmedik bir anda şüpheli olarak ölen olguların adli olgu kapsamında değerlendirilerek gereksizce adli işlem yapılmasının da önüne geçilebilecektir.Anahtar kelimeler: Aort rüptürü, ani ölüm, aort anevrizması, otopsi, adli tıp. ABSTRACTAortic dissection of the aorta is the most common fatal disease requires urgent diagnosis and treatment. The most important step in the diagnosis of aortic dissection which is characterized by sudden onset of chest pain in predatory manner is the clinical suspicion. Especially in patients who present with atypical symptoms is difficult to diagnose. The mortality rate is increasing by 1-2% every hour if left untreated. In this study we presented a fifty-two-year-old female case with atypic symptoms, such as nausea and vomiting, admitted to the emergency room. The patient admitted to the emergency department with only nausea and vomiting complaints and at the end of the examination it was decided that there were no cardiac pathology. Six hours later, the overall situation has deteriorated, and the patient died. In the autopsy we revealed two pericardial rupture in the front pericardial area, also there was 8.5 cm long identified ruptured aortic dissection beginning from the ascending aorta to the root of aorta, which was the cause of death. Delays in diagnosis of aortic dissection can lead to death, also the physicians can face with important legal issues. Early diagnosis of patients, who died suddenly and unexpected, can avoid unnecessary judicial proceedings.

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“…The most common symptom of acute aortic dissection is pain (2), but painless aortic dissection has been reported in 6% of patients in one study (6). However, patients may present with symptoms related to AD complications, such as heart failure, acute stroke, syncope, acute myocardial infarction, ischemic peripheral neuropathy, paraplegia, and cardiac arrest or sudden death.…”

Section: Discussionmentioning

confidence: 99%

A Case of Aortic Dissection Complicating Right Subclavian Artery Occlusion and Mimicking Inferior Myocardial Infarction

Doksöz¹,

Öztürk²,

Salha³

et al. 2017

J Emerg Med Case Rep

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Introduction: Acute aortic dissection is the most common catastrophic event affecting the aorta. Aortic dissection can present with a wide range of manifestations and is easily misdiagnosed. Case Report: Here we report a case of aortic dissection that was initially misdiagnosed as inferior wall myocardial infarction although the initial symptoms were related to right subclavian artery occlusion caused by a dissection flap. Aortic dissection was diagnosed after the patient underwent coronary angiography. The patient was managed with immediate surgical repair and was discharged in a stable condition. Conclusion: This case report illustrates the importance of having a high index of suspicion for aortic dissection to avoid a mistaken diagnosis in patients with an electrocardiogram (ECG) suggestive of ST elevation myocardial infarction (STEMI).

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Association of Painless Acute Aortic Dissection With Increased Mortality

Cited by 181 publications

References 21 publications

Editor's Choice – Management of Descending Thoracic Aorta Diseases

Editor's Choice – Management of Descending Thoracic Aorta Diseases

Dissekan Aort Anevrizması Rüptürüne Bağlı Ani Ölüm Olgusu

A Case of Aortic Dissection Complicating Right Subclavian Artery Occlusion and Mimicking Inferior Myocardial Infarction

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