Clinical Significance and Impact of "Painless" Acute Aortic Dissection

Matsuo, Hiroshi

doi:10.1253/circj.cj-10-1149

Cited by 10 publications

(4 citation statements)

References 6 publications

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“…Therefore, markers are required for suspected AAD. The incidence of decreased blood pressure is unclear, but caution is needed in patients who do not have especially high blood pressure in the acute stage, despite a history of hypertension [16]. In our study, there was no significant difference in blood pressure between the AAD and AIS groups.…”

Section: Discussioncontrasting

confidence: 55%

急性虚血性脳卒中と急性大動脈解離の鑑別診断におけるフィブリノゲン/フィブリン分解産物の有用性

Nihei

Arai

Uchida

et al. 2018

J UOEH

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A post-marketing surveillance study reported fatalities following tissue plasminogen activator administration in acute aortic dissection (AAD) with the symptoms of acute ischemic stroke (AIS) patients. Therefore, it is important to discriminate AAD from AIS. The present study aimed to investigate whether fibrinogen/fibrin degradation products (FDP) value can be useful in differential diagnosis between AAD and AIS. The study group comprised 20 AAD patients (10 men and 10 women; age 63.9 ± 13.6 years) and 159 AIS patients (91 men and 68 women; age 74.2 ± 10.6 years) who were transported to our hospital from 2007 to 2012. The AAD cases were further divided into patent-type AAD and thrombosed-type AAD. FDP values were significantly higher in the AAD group than in the AIS group (18.15 [5.2 - 249.9] μg/ml vs. 2.3 [1.5 - 4.45] μg/ml ; P < 0.001). In AAD groups, FDP values were significantly higher in the patent-type AAD group (n = 9) than in the thrombosed type AAD group (n = 11) (293.2 μg/ml [63.1 - 419.6 μg/ml ] vs. 5.6 μg/ml [3.8 - 7.9 μg/ml ]. FDP values were significantly higher in patients with AAD than in those with AIS, especially those with patent-type AAD compared with AIS patients. High FDP values may be a useful marker for differential diagnosis between patent-type AAD and AIS.

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Section: Discussioncontrasting

confidence: 55%

急性虚血性脳卒中と急性大動脈解離の鑑別診断におけるフィブリノゲン/フィブリン分解産物の有用性

Nihei

Arai

Uchida

et al. 2018

J UOEH

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“…To help acknowledge more this type of AD, we seeked for variable clinical presentation and we found that patient generally presents with hypotension wish could be secondary to aortic regurgitation generally when the aortic valve is involved [11] , cardiac tamponade with high mortality [12] and heart failure [7][8][9][10][11][12][13] wish confers to a higher morbidity and mortality [14], and then bradycardia due the involvement of the baroreceptors and also the extent of the dissection to the right common carotid wish may cause also syncope [15]. This also explains the high incidence of right hemispheric ischemia and hence left side neurological deficits [16].…”

Section: Discussion:-mentioning

confidence: 99%

Painless Acute Aortic Dissection: Be Aware of Misdiagnosis and Ruling Out a Serious Danger.

Bentahar¹

2019

IJAR

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“…These patients have worse outcomes and may have a delay in diagnosis. 33 Patients who are hypotensive (SBP < 80 mmHg) are more likely to have painless dissections. Hypotension on initial presentation to the ED has been found to be an independent correlate of in‐hospital mortality.…”

Section: Reviewmentioning

confidence: 99%

Diagnosing aortic dissection: A review of this elusive, lethal diagnosis

Briggs,

Cline

2024

JACEP Open

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Aortic dissection (AD) remains a difficult diagnosis in the emergency setting. Despite its rare occurrence, it is a life‐threatening pathology that, if missed, is typically fatal. Previous studies have documented minimal improvement in timely and accurate diagnoses despite the advancement of computed tomography. Previous literature has highlighted aortic dissections as a major cause of serious misdiagnosis‐related harm. The aim of this article is to review the available literature on AD, discussing the diversity in presentations and the prevalence of historical and exam features to better aid in the diagnosis of AD. AD remains a difficult diagnosis, even with the widespread prevalence of computed tomography angiography usage. No single feature of the history or physical examination is enough to raise suspicion. The diagnosis should be strongly considered in any patient with chest pain that is severe and unexplained by other findings or testing. Those who do not present with acute pain are often complicated by neurologic deficits, hypotension, or syncope. These patients suffer from a change in mental status limiting their ability to participate in the history and physical examination and have a higher rate of complications and mortality. An educated understanding of the atypical presentations of aortic dissection helps the clinician to realistically rank it on the differential diagnosis, culminating in judicious use of definitive imaging.

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Clinical Significance and Impact of "Painless" Acute Aortic Dissection

Cited by 10 publications

References 6 publications

急性虚血性脳卒中と急性大動脈解離の鑑別診断におけるフィブリノゲン/フィブリン分解産物の有用性

急性虚血性脳卒中と急性大動脈解離の鑑別診断におけるフィブリノゲン/フィブリン分解産物の有用性

Painless Acute Aortic Dissection: Be Aware of Misdiagnosis and Ruling Out a Serious Danger.

Diagnosing aortic dissection: A review of this elusive, lethal diagnosis

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