title: [Acute aortic dissection].
abstract: OBJECTIVE
  Acute aortic dissection is a medical emergency associated with high rates of mortality. Despite recent diagnostic advances, prompt and accurate diagnosis is difficult. We present a review of the a medical emergency service experience to diagnosis, factors associated to prompt diagnosis and inhospital evolution.
  
  
  METHODS
  We studied 86 consecutive patients who had aortic dissections, to assess the presentation, management, and outcome.
  
  
  RESULTS
  Mean age 61.9 +/- 12.5 years, 80% male. Hypertension was the most common predisposing factor (65% of patients overall). Chest pain was the most common initial complaint (58%). The initial clinical impression was aortic dissection in 56% of patients overall. Computed tomography was diagnostic in 96% when used. 62% underwent surgery. Overall in-hospital mortality was 28%.
  
  
  CONCLUSIONS
  Acute aortic dissection presents with a wide range of manifestations. A high clinical index of suspicion and a prompt computed tomography should to improve recognition of aortic dissection.
authors.affiliation: Sección de Medicina de Urgencia, Hospital General Universitario Gregorio Marañón, Madrid.
authors.forename: A
authors.initials: A
authors.lastname: Muiño Míguez
authors.forename: M V
authors.initials: MV
authors.lastname: Villalba García
authors.forename: C
authors.initials: C
authors.lastname: López González-Cobos
authors.forename: M
authors.initials: M
authors.lastname: Gómez Antúnez
authors.forename: M
authors.initials: M
authors.lastname: Ortiz Vega
authors.forename: J
authors.initials: J
authors.lastname: Ortiz Alonso
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000175:diagnosis*; D001014:Aortic Aneurysm / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged