Assessment of Patients Diagnosed With Aortic Dissection in Our Emergency Department During the Past Five Years

Year 2019, Volume: 1 Issue: 1, 25 - 28, 23.04.2019

Hakan Oğuztürk

Abstract

Background: The aortic dissection is a cardiovascular emergency with
a high mortality rate which needs emergent rapid diagnosis and treatment. The
patients admitted to ED who have been diagnosed as aortic dissection discussed
in this retrospective study aiming demonstration of demographic features.

Material and Methods: Between August 2010 - August 2015 about 40 patients
who admitted to Inonu university hospital ED have been diagnosed as aortic dissection
discussed in this retrospective study. Patients files evaluated; the age, sex,
past medical history, chief complaints, the duration between onset of complaint
and admission to ED, blood pressure and other vital signs, echocardiographic
changes, and whether there was aortic insufficiency or not were evaluated

Results: All patients’
chief complaint was chest pain. About 75% of patients were admitted to
emergency department within first 24 hour of onset of chest pain De Bakey type1,
type 2 and type 3 were discussed as 70 %, 22.5%, and 7.5% respectively.  20% patients
were hypertensive and 17.5% were hypotensive. 35% of patient’s blood urea level
were elevated. 95% of all these patients’ undergone surgical operation, and
reminder 5% patients medically followed up.  At the end 82.5% of patients discharged with a
full recovery while 17.5% died.

Conclusions: Aortic dissection is highly mortal cardiovascular
emergency in our country which requires rapid diagnosis and evaluation by ED
physician in order to decide the appropriate treatment options without time
loss.

Keywords

Emergency Department, Aortic Dissection, Diagnosis

References

• References 1. Mukherjee D, Eagle KA. Aortic dissection-an update. Curr Probl Cardiol 2005; 30: 287-325.2. Coady MA, Rizzo JA, Elefteriades JA. Pathologic variants of thoracic aorta dissection: penetrating atherosclerotic ulcers and intramural hematomas. Cardiol Clin 1999; 17: 637-57.3. Hagan PG, Nienaber CA, Isselbacher EM, Bruckman D, Karavite DJ, Russman PL, et al. The international registry of acute aortic dissection (IRAD): new insights into an old disease. JAMA 2000; 283: 897-903.4. Svensson LG, Crawford ES. Aortic dissection and aortic aneurysm surgery: clinical observations, experimental investigations, and statistical analyses. Part II. Curr Probl Surg 1992; 29: 915-1057. 5. Cebicci H, Salt O, Gurbuz S, Sahin T, Cumaoglu M.O, Koyuncu S. Atypical presentations of aortic dissections: A case series. Acta Medica Mediterranea, 2014; 30: 85-90.6. De Bakey ME, McCollum CH, Crawford ES, Morris GC Jr, Howell J, Noon GP, et al. Dissection and dissecting aneurysms of the aorta: twenty year follow-up of five hundred twenty seven patients treated surgically. Surgery 1982; 92: 1118-34.7. Neri E, Toscano T, Papalia U, Frati G, Massetti M, Capannini G, et al. Proximal aortic dissection with coronary malperfusion: presentation, management and outcome. J Thorac Cardiovasc Surg. 2001; 121: 552-60.8. Korkut S, Çıkman M, Kandiş H, Karapolat S, Güneş H. Acil serviste ayak ağrısının nadir bir sebebi: Aort diseksiyon olgusu. Konuralp Tıp Dergisi 2010; 2: 22-4.9. Akgün FS, Turtay MG, Dişli OM, Oğuztürk H, Doğan M. Bacak ağrısıyla karakterize akut aort diseksiyonu. Genel Tıp Derg 2011; 21(4): 155-157.10. Erbel R, Engberding R, Daniel W, Roelandt J, Visser C, Rennollet H. Echocardiography in diagnosis of aortic dissection. Lancet 1989; 1: 457-61.11. Nienaber CA, von Kodolitsch Y. Disease of the aorta. Cardiol Clin 1998; 16: 295-314.12. Açıkalın A, Satar S, Akpınar O, Kuvandık G, Sarı A, Kanadaşı M, et al. Aort diseksiyonu: Bir üniversite hastanesi acil servisine başvuran hastalarda iki yıllık klinik deneyim. Türkiye Acil Tıp Dergisi 2005; 5: 32-5.13. Borst HG, Heinemann MK, Stone CD. Alternative procedures. In: Borst HG, Heinemann MK, Stone CD, Eds. Surgical treatment of aortic dissection. New York: Churchill Livingston; 1996: 285-93.14. Kıykım AA. Akut böbrek yetmezliği nedenlerine genel bakış. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 2006; 15 (Supplement 1): 5-12.15. Buket S, Apaydın A, Hamulu A, Özbaran M, Aşkar F, Sakarya M. Akut aort diseksiyonlarında cerrahi tedavi. GKD Cer Derg 1995; 3: 147-52.16. Yeşilaras M, Sönmez N, Karcıoğlu Ö, Topaçoğlu H, Aksakallı S, Bayram B. Acil serviste aort diseksiyonu tanısı almış olan hastaların klinik özelliklerinin tanımlanması: Olgu serisi. Türkiye Acil Tıp Dergisi 2006; 6: 1-6.17. Minale C, Splittgerber FH, Reifschneider HJ. Replacement of the entire thoracic aorta in a single stage. Ann Thorac Surg 1994; 57: 850-5.18. Miller DC. The continuing dilemma concerning medical versus surgical management of patients with acute type B dissections. Seminars in Thoracic and Cardiovascular Surgery1993; 5: 33-46.19. Buket S, Yağdı T, Hamulu A, et al. Distal dejeneratif aort anevrizmalarına cerrahi. In: Buket S, Yağdı T, editörler. Aort Cerrahisi. İstanbul: Yüce Reklam Dağıtım; 2003: 306-346.20. Ikonomidis JS, Weisel RD, Mouradian MS, Ivanov J, Baird RJ, Mickleborough LL, et al. Thoracic aortic surgery. Circulation 1991; 84: 1-6.21. Anagnostopoulos CE, Prabhakar MJ, Kittle CF. Aortic dissections and dissecting aneurysms. Am J Cardiol, 1972; 30(3): 263-73.