title: Aortic Dissection and Sudden Unexpected Deaths: A Retrospective Study of 31 Forensic Autopsy Cases.
abstract: Acute aortic dissection (AAD) is the most common cause of sudden unexpected death related to aortic diseases. A retrospective study of 31 sudden unexpected deaths caused by AAD was conducted at Xi'an Jiaotong University Forensic Center from 2001 to 2012. We summarized the forensic characteristics of AAD and assessed the clinically diagnostic accuracy of AAD. The characteristics of sudden unexpected death due to AAD were male predominant (male: female=6.7:1), relatively young with the mean age of 44, and predominance of type A dissection (77.4%). Cardiac tamponade was the most frequent cause of sudden death (87.1%). Of the 31 cases, 26 (83.9%) patients were not recognized clinically and were misdiagnosed with acute myocardial infarction, coronary artery disease, cholecystitis, acute gastroenteritis, renal/urinary lithiasis, or acute pancreatitis. In summary, AAD can be difficult to recognize, diagnosis is therefore sometimes delayed or missed. The medicolegal death investigation can help physicians have a better understanding of AAD.
authors.affiliation: School of Forensic Medicine, Xi'an Jiaotong University, Shaanxi, 710061, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Office of the Chief Medical Examiner, 900 West Baltimore Street, Baltimore, MD, 21223.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.affiliation: Xian'yang Wei-cheng Public Security Bureau, Shaanxi, 712000, China.
authors.forename: Hong-Shu
authors.initials: HS
authors.lastname: Mu
authors.affiliation: School of Forensic Medicine, Xi'an Jiaotong University, Shaanxi, 710061, China.
authors.forename: Shuan-Liang
authors.initials: SL
authors.lastname: Fan
authors.affiliation: Office of the Chief Medical Examiner, 900 West Baltimore Street, Baltimore, MD, 21223.
authors.forename: Fang-Gang
authors.initials: FG
authors.lastname: He
authors.affiliation: School of Forensic Medicine, Xi'an Jiaotong University, Shaanxi, 710061, China.
authors.forename: Zhen-Yuan
authors.initials: ZY
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D063194:Adventitia / Q000473:pathology; D000368:Aged; D001011:Aorta / Q000293:injuries* / Q000473:pathology*; D002305:Cardiac Tamponade / Q000150:complications; D003645:Death, Sudden / Q000209:etiology*; D003951:Diagnostic Errors; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D009929:Organ Size; D012189:Retrospective Studies; D055815:Young Adult
keywords: aortic dissection; forensic autopsy; forensic science; medical tangle; medicolegal investigation; sudden death