Electrocardiographic changes in patients with type A acute aortic dissection

Hirata, Kazuhito; Wake, Minoru; Kyushima, Masahiro; Takahashi, Takanori; Nakazato, Jun; Mototake, Hidemitsu; Tengan, Toshiho; Yagi, Hiroshi; Henzan, Eisei; Miyashita, Masao; Asato, Hiroaki

doi:10.1016/j.jjcc.2010.03.007

Cited by 36 publications

(16 citation statements)

References 25 publications

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“…6,7 In addition, ECG change in patients with aortic dissection is rare. A previous study 5 identified that the incidence was 1.3% (2 of 159 cases).…”

Section: Discussionmentioning

confidence: 93%

“…[1][2][3][4] Our patient presented with fever, pericardial effusion, and diffuse ST-segment elevation on ECG, a combination of which strongly suggested acute pericarditis. Although up to 30% of patients with acute aortic dissection have pericardial effusion (sometimes with tamponade), 5 acute pericarditis with a small amount of pericardial effusion is rare as an initial manifestation of aortic dissection. We are aware of only several case reports, mostly in younger populations.…”

Section: Discussionmentioning

confidence: 99%

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Diffusely Elevated ST Segments on Electrocardiography

2016

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A man in his early 70s walked into the emergency department with a 4-day history of fever and tingling sensation in the chest. His medical history was significant with hypertension, intracranial hemorrhage, and chronic kidney disease (CKD). On arrival, his blood pressure was 130/64 mm Hg, heart rate was 104 beats/min, respiratory rate was 32 breaths/ min, body temperature was 37.1°C, and arterial oxygen saturation was 95% on room air. There was no murmur, rub, or gallop in chest auscultation. Electrocardiographic (ECG) findings were significant for diffuse STsegment elevation (Figure 1, A). Laboratory examination revealed leukocytosis with normal cardiac enzyme levels and mild renal dysfunction (serum creatinine, 1.4 mg/dL [to convert to micromoles per liter, multiply 88.4]). The C-reactive protein level was also elevated. He was admitted to the hospital with the suspected diagnosis of acute pericarditis. After admission, his chest discomfort resolved in 2 days, but he was still febrile, and pericardial effusion did not decrease. Computed tomography (CT) of the chest was performed (Figure 1, B and C).

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“…6,7 In addition, ECG change in patients with aortic dissection is rare. A previous study 5 identified that the incidence was 1.3% (2 of 159 cases).…”

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Diffusely Elevated ST Segments on Electrocardiography

2016

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“…The clinical presentation of dissection patients may be diverse, and sudden collapse or an altered state of consciousness have been reported to be the presenting symptom in up to 30% of all patients [6]. This report also included TAAAD patients, which are more prone to develop complications like syncope or alteration in consciousness [7].…”

Section: Discussionmentioning

confidence: 99%

Painless Type B Aortic Dissection: Insights From the International Registry of Acute Aortic Dissection

Tolenaar

Hutchison

Montgomery

et al. 2013

aorta

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Painless TBAAD is a relatively rare presentation (3.7%) of aortic dissection, and is often associated with a history of atherosclerosis, diabetes, prior aortic disease including aortic aneurysm, and an iatrogenic origin. We observed a trend for increased in-hospital mortality in painless TBAAD patients, which may be the result of a delay in diagnosis and management. Therefore, physicians should be aware of this relative rare presentation of TBAAD.

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confidence: 99%

“…Previous studies have demonstrated that acute electrocardiographic changes are commonly noted in patients with AAD ( 3 , 4 ). ST elevation is observed in patients with coronary malperfusion, a condition that develops in 5-8% of patients with AAD ( 3 , 4 ). Acute ST depression and T wave changes are common, especially when patients exhibit cardiac tamponade and shock, even without overt coronary malperfusion ( 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

Acute Aortic Dissection Masquerading as Acute Pericarditis

et al. 2020

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We herein report 3 cases of acute aortic dissection (AAD) in which the initial 12-lead electrocardiogram showed typical ST elevation consistent with acute pericarditis. All patients exhibited small pericardial effusion but did not suffer from rupture into the pericardium or clinical tamponade. Slow leakage or exudate stemming from the dissecting hematoma appeared to have caused inflammation, resulting in pericarditis. Therefore, we highlight the fact that AAD may masquerade as acute pericarditis. Physicians should be aware of the possibility of type A AAD as an important underlying condition, since the early diagnosis and subsequent surgical treatment may save patients' lives.

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Electrocardiographic changes in patients with type A acute aortic dissection

Abstract: Acute ECG changes were common in type A AAD. Physicians taking care of patients with chest pain and acute ECG changes should consider the possibility of AAD before performing thrombolysis or percutaneous catheter intervention.

Cited by 36 publications

References 25 publications

Diffusely Elevated ST Segments on Electrocardiography

Diffusely Elevated ST Segments on Electrocardiography

Painless Type B Aortic Dissection: Insights From the International Registry of Acute Aortic Dissection

Acute Aortic Dissection Masquerading as Acute Pericarditis

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