Diagnosis of acute symptomatic aortic aneurysm--ultrasonography an important tool

Symptomatic aortic aneurysm is an extremely acute condition with manifest or threatening aortic rupture. The mortality is high and urgent surgery is essential and often life-saving. A correct diagnosis needs to be made without delay, a fact which places great demands on the doctor--often not a surgeon--who is first consulted by the patient. The differential diagnosis and emergency management are discussed here against the background of the course of events in four patients with aortic aneurysm who were referred erroneously for admission to a coronary intensive care unit during a 12-month period. Two of the patients died. The ultrasonographic findings were decisive for the outcome in the two surviving patients and yielded a rapid diagnosis in one further case. Ultrasonography is recommended as the method of first choice for verifying or excluding this condition when it is suspected on clinical grounds.