Speciality
Spotlight

 




 


Cardiology


 


   





Aortic
Dissection

  

  • Hagan PG, Nienaber CA, Isselbacher EM, et al (Univ of Michigan, Ann Arbor; Massachusetts Gen Hospital, Boston; Univ of Massachusetts, Worcester; et al)

    The International Registry of Acute Aortic Dissection (IRAD); New Insights Into an Old Disease

    JAMA 283: 897-903, 2000

      

    Acute aortic dissection is a medical emergency associated with high rates of morbidity and mortality. Presenting signs can be diverse and diagnosis is difficult. The International Registry of Acute Aortic Dissection (IRAD) was established in 1996 to evaluate, correlate the current status of presentation, management, and outcomes of acute aortic dissection.

      

    The study group consisted of 464 patients; average age was 63 and majority were male. Type A dissections, defined as involving the ascending aorta, occurred in 62%; Type B, involving aorta distal to the left subclavian artery, tended to occur in older patients. The most common symptom was severe sharp pain with abrupt outset in 85% of the patients. Hypertension was more common in those with Type B dissection. No chest abnormality was detected in 12% and mediastinal widening and abnormal aortic contour were not seen in 21%. ECG showed no abnormality in 31%. CT was the most common initial imaging method. Of the 289 patients with Type A dissection 72% were managed surgically. Overall in-hospital mortality was 28%. Highest mortality (58%) occurred in Type A patients who did not have surgery. Patients with Type B dissection who were treated medically had mortality of 11% which rose to 31% in those who underwent surgery. Female patients tended to be older and had higher mortality than male patients. Thus acute aortic dissection is characterized by rapid development of deterioration and high morbidity and mortality. Typical presentation is sudden severe pain. Clinical manifestations are diverse and many of the classic symptoms absent. High degree of suspicion is necessary for diagnosis. Improvements are still needed in the methods used to diagnose and manage acute aortic dissection.

         




 

 

Speciality Spotlight

 

   

Aortic Dissection
  

  • Hagan PG, Nienaber CA, Isselbacher EM, et al (Univ of Michigan, Ann Arbor; Massachusetts Gen Hospital, Boston; Univ of Massachusetts, Worcester; et al)
    The International Registry of Acute Aortic Dissection (IRAD); New Insights Into an Old Disease
    JAMA 283: 897-903, 2000
      
    Acute aortic dissection is a medical emergency associated with high rates of morbidity and mortality. Presenting signs can be diverse and diagnosis is difficult. The International Registry of Acute Aortic Dissection (IRAD) was established in 1996 to evaluate, correlate the current status of presentation, management, and outcomes of acute aortic dissection.
      
    The study group consisted of 464 patients; average age was 63 and majority were male. Type A dissections, defined as involving the ascending aorta, occurred in 62%; Type B, involving aorta distal to the left subclavian artery, tended to occur in older patients. The most common symptom was severe sharp pain with abrupt outset in 85% of the patients. Hypertension was more common in those with Type B dissection. No chest abnormality was detected in 12% and mediastinal widening and abnormal aortic contour were not seen in 21%. ECG showed no abnormality in 31%. CT was the most common initial imaging method. Of the 289 patients with Type A dissection 72% were managed surgically. Overall in-hospital mortality was 28%. Highest mortality (58%) occurred in Type A patients who did not have surgery. Patients with Type B dissection who were treated medically had mortality of 11% which rose to 31% in those who underwent surgery. Female patients tended to be older and had higher mortality than male patients. Thus acute aortic dissection is characterized by rapid development of deterioration and high morbidity and mortality. Typical presentation is sudden severe pain. Clinical manifestations are diverse and many of the classic symptoms absent. High degree of suspicion is necessary for diagnosis. Improvements are still needed in the methods used to diagnose and manage acute aortic dissection.
         

 

By |2022-07-20T16:42:29+00:00July 20, 2022|Uncategorized|Comments Off on Aortic Dissection

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