[Aortic dissection--a differential diagnosis in patients with chest pain and ECG changes].
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.
Fossum
Eigil
E
Hjerte-Lungesenteret, Ullevål universitetssykehus, Oslo. eigil.fossum@ioks.uio.no
Ata
Bilal
B
Eritsland
Jan
J
Kløw
Nils-Einar
NE
Mangschau
Arild
A
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