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[Acute aortic dissection]
A Muiño Míguez1, M V Villalba García, C López González-Cobos
1Sección de Medicina de Urgencia, Hospital General Universitario Gregorio Marañón, Madrid.
Objective:
Acute aortic dissection is a medical emergency associated with high rates of mortality. Despite recent diagnostic advances, prompt and accurate diagnosis is difficult. We present a review of the a medical emergency service experience to diagnosis, factors associated to prompt diagnosis and inhospital evolution.
Material And Method:
We studied 86 consecutive patients who had aortic dissections, to assess the presentation, management, and outcome.
Results:
Mean age 61.9 +/- 12.5 years, 80% male. Hypertension was the most common predisposing factor (65% of patients overall). Chest pain was the most common initial complaint (58%). The initial clinical impression was aortic dissection in 56% of patients overall. Computed tomography was diagnostic in 96% when used. 62% underwent surgery. Overall in-hospital mortality was 28%.
Conclusions:
Acute aortic dissection presents with a wide range of manifestations. A high clinical index of suspicion and a prompt computed tomography should to improve recognition of aortic dissection.