title: [Aortic dissection--a differential diagnosis in patients with chest pain and ECG changes].
abstract: BACKGROUND
  The effect of thrombolytic therapy in patients with myocardial infarction is well documented. In patients presenting with chest pain it may, however, be difficult to discriminate between myocardial infarction and aortic dissection only on the basis of clinical manifestations. Moreover, patients with type A dissection may have ECG changes caused by affection of the coronary flow.
  
  
  METHODS
  We retrospectively investigated all patients admitted to our hospital with type A dissection of the aorta over the period 1999 to March 2001.
  
  
  RESULTS
  Fourteen patients were identified. Only two patients had normal ECG, six had ST elevation. Two patients had received antithrombotic or thrombolytic therapy.
  
  
  CONCLUSIONS
  In patients with chest pain and ST elevation, aortic dissection must be considered as a differential diagnosis before thrombolytic therapy.
authors.affiliation: Hjerte-Lungesenteret, Ullevål universitetssykehus, Oslo. eigil.fossum@ioks.uio.no
authors.forename: Eigil
authors.initials: E
authors.lastname: Fossum
authors.forename: Bilal
authors.initials: B
authors.lastname: Ata
authors.forename: Jan
authors.initials: J
authors.lastname: Eritsland
authors.forename: Nils-Einar
authors.initials: NE
authors.lastname: Kløw
authors.forename: Arild
authors.initials: A
authors.lastname: Mangschau
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis*; D000787:Angina Pectoris / Q000175:diagnosis*; D001013:Aorta, Thoracic; D001014:Aortic Aneurysm / Q000175:diagnosis*; D000075202:Contraindications; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis; D012189:Retrospective Studies; D015912:Thrombolytic Therapy