[Aortic dissection - a not so rare disease].
OBJECTIVE
Acute aortic dissection is a life-threatening disease with a high rate of mortality. The dissection of the artery with a distal blood flow can explain the variable and changeable symptoms. Aortic dissections require immediate diagnosis and therapy.


METHODS
In the Institute of Legal Medicine of the Hannover Medical School, 34 cases of aortic dissection were found during autopsy between 2006 and 2009. The cases were analysed retrospectively.


RESULTS
In the majority of cases (55.9%) an antemortem medical consultation has taken place. In only one case an aortic dissection could be diagnosed at a later time.


CONCLUSIONS
Key in the management of acute aortic dissection is to maintain a high clinical index of suspicion for this diagnosis. Etiologically hereditary diseases (Marfan syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome) should be taken into consideration as a possible cause. In all unexpected deaths of young adults an autopsy should be performed to detect the cause of death and for genetic testing to provide information for the relatives in case an aortic aneurysm can be found.
Institut für Rechtsmedizin der Medizinischen Hochschule Hannover, Hannover, Germany. jaenisch.stefanie@mh-hannover.de
Stefanie
S
Jänisch
Nurzhan
N
Turmanov
Urs-Vito
UV
Albrecht
Armin
A
Fieguth
Detlef
D
Günther
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000175:diagnosis* / Q000235:genetics / Q000401:mortality* / Q000473:pathology; D001011:Aorta / Q000473:pathology; D001013:Aorta, Thoracic / Q000473:pathology; D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000235:genetics / Q000401:mortality* / Q000473:pathology; D002305:Cardiac Tamponade / Q000175:diagnosis / Q000401:mortality / Q000473:pathology; D002423:Cause of Death; D057210:Delayed Diagnosis; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
N Engl J Med. 2006 Aug 24;355(8):788-98
16928994
Eur Heart J. 2001 Sep;22(18):1642-81
11511117
Am J Cardiol. 1995 Jan 15;75(2):157-60
7810492
Surgery. 1982 Dec;92(6):1103-8
7147188
JAMA. 2000 Feb 16;283(7):897-903
10685714
Forensic Sci Int. 1993 May;59(2):149-55
8330807
Am J Cardiol. 2007 Mar 15;99(6):852-6
17350381
Arch Pathol Lab Med. 1982 Apr;106(4):175-80
6895989
Internist (Berl). 2009 Aug;50(8):964-71
19565210
Z Kardiol. 1998 Feb;87(2):94-9
9556871
J Emerg Med. 2002 Feb;22(2):171-4
11858922
Ann Thorac Surg. 2006 Oct;82(4):1400-5
16996941
Emerg Med Clin North Am. 2005 Nov;23(4):937-57
16199332
Forensic Sci Int. 2009 May 30;187(1-3):1-5
19285815
BMC Res Notes. 2009 Feb 20;2:25
19284704
Arch Intern Med. 2000 Oct 23;160(19):2977-82
11041906
Emerg Med J. 2006 Mar;23(3):e24
16498148
Dtsch Med Wochenschr. 1971 Apr 9;96(15):646-7
5552849
Curr Probl Cardiol. 1989 May;14(5):225-78
2663378
Int J Legal Med. 2009 Jan;123(1):55-8
18925407
Mayo Clin Proc. 1993 Jul;68(7):642-51
8350637
Medicine (Baltimore). 1958 Sep;37(3):217-79
13577293