Clinical Analysis Of 31 Aortic Dissection Cases

Objective:Aortic dissection(AD)is a life-threatening condition that requiring immediate diagnosis and therapy.A patient suffering from AD often presents with an insignificant medical history,leading to possible misdiagnosis.The aim of this retrospective study is to analyse the clinical feature of AD and expect to reduce the misdiagnosis rate and mortality rate.Methods:From January 2010 to December 2016,thirty-one patients presented to our hospital and finally diagnosed with AD.The age,gender,high risk factors,clinical manifestations and examinations of these patient were statistically analysed.Result:Twenty-four of those patients suffered from severe pain.Eleven presented with thoracodorsal pain and thirteen presented with lumbo-abdominal pain.Chest X-ray was conducted in all patients and revealed a widened mediastinum in four patients.Ultrasonic cardiogram was performed in all patients and revealed possibility of AD in nineteen patients.Only four patients received coronary angiography and two were normal.D-dimer was tested in twenty-one patients and the rise was found in seventeen patients.CT was performed in twenty-seven patients and confirmed the diagnosis of these patients.Four patients accepted MRI and were diagnosed.Initial misdiagnosis occurred in eight patients later found to be suffering from AD.Endovascular repair surgery was operated in eighteen patients.Nine patients were treated with medical therapy alone.Seven patients died in hospital.Conclusion:The morbidity of AD in male is higher than it in female.Hypertension is the major motivation.The most common clinical manifestation is a sudden sever thoracic or abdominal pain.Aortic CTA and MRI are the most accurate imaging methods to diagnose AD.Presenting with a variety of clinical manifestations,Aortic dissection can be easily misdiagnosed and the mortality rate of are high.Clinicians should be aware of aortic dissection and enhance the vigilance of it.