Multidetector-row CT evaluation of nontraumatic acute thoracic aortic syndromes

Romano, Luigia; Pinto, Ángel González; Gagliardi, N.

doi:10.1007/s11547-007-0116-x

Cited by 21 publications

(4 citation statements)

References 69 publications

(136 reference statements)

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“…CT scans are fast, noninvasive tests that give an accurate 3‐dimensional view of the aorta. CT has traditionally been the initial study performed; however, with the rise in new technology (eg, multidetector‐row CT), important diagnostic possibilities and very interesting future perspectives are afforded 16,18 …”

Section: Discussionmentioning

confidence: 99%

Misdiagnosis of Aortic Dissection: Experience of 361 Patients

Sun¹,

Shen²,

Li³

et al. 2012

J of Clinical Hypertension

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J Clin Hypertens (Greenwich). 2012;14:256–260. ©2012 Wiley Periodicals, Inc. Aortic dissection (AD) is a life‐threatening condition that requires immediate diagnosis and surgical correction. Patients with acute AD usually present clinically with an insignificant medical history, leading to a high probability of misdiagnosis. The aim of the present study was to investigate the number of misdiagnoses of patients with AD in order to understand this problem and to avoid future misdiagnosis in the emergency department. Clinical data from 361 patients with AD admitted between January 2003 and June 2008 were reviewed as part of a retrospective chart review. Diagnosis of AD was made using either chest x‐ray, computed tomography, magnetic resonance imaging, or angiography. Fifty‐one patients had an initial misdiagnosis (14.1%), later found to have experienced AD. The condition may clinically present in a varied number of manifestations, including syncope, chest pain, abdominal pain, back pain, acute congestive heart failure, or alternatively with minimal symptoms. Persons of any age can experience an AD, with key clinical manifestations of pain. Echocardiography can be used for primary examination of patients with suspected AD; however, a definite diagnosis is usually made using computed tomographic or magnetic resonance angiography. Care should be taken, particularly in the emergency department, to maintain a level of suspicion for AD diagnosis in order to avoid the potential for misdiagnosis.

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Section: Discussionmentioning

confidence: 99%

Misdiagnosis of Aortic Dissection: Experience of 361 Patients

Sun¹,

Shen²,

Li³

et al. 2012

J of Clinical Hypertension

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“…Spiral BT'nin aort diseksiyonu tanısında duyarlılık oranının % 83-100, özgüllük oranının ise % 87-100 olduğu bildirilmiştir (23). Multidetektor-row bilgisayarlı tomografi (MDCT)'nin aort diseksiyonu tanısı için % 100'e yakın duyarlılık ve özgüllüğe sahip olup kısa zaman içerisinde üç boyutlu vasküler görüntüler sağlayarak sadece tanı amacıyla değil, aynı zamanda tedavinin planlanmasında da önemli bir rol oynayacağı bildirilmiştir (24). Bizim olgumuzun non-spesifik şikayetlerinin olması ve hastaneye başvurusundan kısa bir süre sonra ölmesi nedeniyle görüntülemeye yönelik herhangi bir tetkik imkanı olmamıştır.…”

Section: Resim 3 çıKan Aortu Tutan Tip 2 Aort Diseksiyonuunclassified

Dissekan Aort Anevrizması Rüptürüne Bağlı Ani Ölüm Olgusu

İlhan¹,

Beyaztaş²,

Bütün³

et al. 2014

Bull Leg Med

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ÖZETAort diseksiyonu aortanın en sık rastlanan ölümcül hastalığı olup, acil tanı ve tedavi gerektirmektedir. Ani başlayan ve yırtıcı vasıftaki göğüs ağrısı ile karakterize olan aort diseksiyonu tanısında en önemli basamak klinik şüphedir. Özellikle atipik yakınmalarla başvuran olgularda tanı koymak oldukça güçtür. Hastalığın mortalitesi, tedavi edilmediği takdirde her saat % 1-2 oranında artmaktadır. Bu çalışmada; bulantı ve kusma gibi atipik yakınmalarla acile başvuran, elli iki yaşında bir kadın olgu sunumu yapılmıştır. Olgu sadece bulantı ve kusma şikayetleri ile acil servise başvurmuş, yapılan muayene ve tetkik sonucunda kardiyak patoloji bulunmadığı belirtilmiştir. Altı saat sonra genel durumu bozulmuş ve ölmüştür. Yapılan otopside; perikart ön yüzde iki adet rüptüre alan olduğu, çıkan aortada tespit edilen rüptüre alandan aort köküne doğru 8.5 cm uzunluğunda diseksiyon olduğu, ölüm nedeninin disekan aort anevrizma rüptürü olduğu saptanmıştır. Aort diseksiyonu tanısındaki gecikmeler ölüme yol açabileceği gibi hekimleri de önemli adli sorunlarla karşı karşıya bırakabilecektir. Ayrıca tanının erken konulması ile beklenmedik bir anda şüpheli olarak ölen olguların adli olgu kapsamında değerlendirilerek gereksizce adli işlem yapılmasının da önüne geçilebilecektir.Anahtar kelimeler: Aort rüptürü, ani ölüm, aort anevrizması, otopsi, adli tıp. ABSTRACTAortic dissection of the aorta is the most common fatal disease requires urgent diagnosis and treatment. The most important step in the diagnosis of aortic dissection which is characterized by sudden onset of chest pain in predatory manner is the clinical suspicion. Especially in patients who present with atypical symptoms is difficult to diagnose. The mortality rate is increasing by 1-2% every hour if left untreated. In this study we presented a fifty-two-year-old female case with atypic symptoms, such as nausea and vomiting, admitted to the emergency room. The patient admitted to the emergency department with only nausea and vomiting complaints and at the end of the examination it was decided that there were no cardiac pathology. Six hours later, the overall situation has deteriorated, and the patient died. In the autopsy we revealed two pericardial rupture in the front pericardial area, also there was 8.5 cm long identified ruptured aortic dissection beginning from the ascending aorta to the root of aorta, which was the cause of death. Delays in diagnosis of aortic dissection can lead to death, also the physicians can face with important legal issues. Early diagnosis of patients, who died suddenly and unexpected, can avoid unnecessary judicial proceedings.

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“…In recent haematoma, there is hyperdensity of the blood in the haematoma associated with wall thickening 13. In contrast studies, a hypodense region is seen which is shaped like a crescent 14. Regional thickening of the aorta may also occur in other settings; IMH must be differentiated from aortitis, thrombus and atheromatous plaque, and magnetic resonance imaging (MRI) may be particularly helpful in this regard 15…”

Section: Diagnosis and Imagingmentioning

confidence: 99%

Aortic intramural haematoma

Bolger

2008

Heart

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Multidetector-row CT evaluation of nontraumatic acute thoracic aortic syndromes

Cited by 21 publications

References 69 publications

Misdiagnosis of Aortic Dissection: Experience of 361 Patients

Misdiagnosis of Aortic Dissection: Experience of 361 Patients

Dissekan Aort Anevrizması Rüptürüne Bağlı Ani Ölüm Olgusu

Aortic intramural haematoma

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