[Acute aortic dissection].
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.
Muiño Míguez
A
A
Sección de Medicina de Urgencia, Hospital General Universitario Gregorio Marañón, Madrid.
Villalba García
M V
MV
López González-Cobos
C
C
Gómez Antúnez
M
M
Ortiz Vega
M
M
Ortiz Alonso
J
J
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