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Aortic dissection in Taiwan
W B Liao1, M J Bullard, C H Chang
1Department of Primary Care Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Japanese Heart Journal
|September 1, 1995
Summary
Spontaneous thoracic aortic dissection, often linked to hypertension, disproportionately affects men and occurs more in colder months. Early identification and aggressive treatment are crucial, as 24% of patients in this study died during hospitalization.
Area of Science:
- Cardiovascular Medicine
- Thoracic Surgery
- Epidemiology
Background:
- Spontaneous thoracic aortic dissection (TAD) is a life-threatening condition.
- Hypertension is a primary risk factor for TAD, affecting 85% of patients in this cohort.
- Marfan syndrome and other underlying conditions were less common predisposing factors.
Purpose of the Study:
- To analyze the clinical characteristics, predisposing factors, and outcomes of spontaneous thoracic aortic dissection.
- To identify demographic and seasonal patterns in TAD presentation.
- To evaluate in-hospital mortality rates for different types of TAD.
Main Methods:
- Retrospective review of 109 patients diagnosed with spontaneous thoracic aortic dissection.
- Data collected included patient demographics, medical history, presenting symptoms, diagnostic classification (Type A vs. Type B), and in-hospital mortality.
- Analysis of seasonal variations and predisposing factors.
Main Results:
- The study included 109 patients (mean age 55 years; 2:1 male-to-female ratio).
- Hypertension was the most common predisposing factor (85%).
- A significant seasonal predilection was observed, with 69% of cases occurring during colder months (September-February). Type A dissection occurred in 46% and Type B in 54% of patients, with an overall in-hospital mortality of 24% (16% for Type A, 8% for Type B).
Conclusions:
- Spontaneous thoracic aortic dissection is a significant concern, particularly in hypertensive patients.
- Patients exhibit increased susceptibility during colder months.
- The study highlights the need for earlier diagnosis and more aggressive antihypertensive management to improve outcomes.