Abstract
Acute aortic dissection is a life-threatening disease unless treated appropriately. Prompt assessment is considered essential for appropriate treatment. Fifty-one consecutive patients (31 men, 20 women, average age 69 years, 23 Stanford type A, 28 Stanford type B) were analyzed retrospectively. Patients were divided into 3 groups according to the time between the first visit and diagnosis: Group I (duration less than 1 hour; 16 patients), Group II (1 to 4 hours; 21 patients), and Group III (more than 4 hours; 14 patients). Although all the patients in Group I suffered from typical chest pain, only 17 patients complained of chest pain in Group II and 5 in Group III. However, high blood pressure, significant laterality of blood pressure, left ventricular hypertrophy in electrocardiogram, and widened mediastinum in chest X-ray film were not observed more frequently in Group I than in the other groups. Patients treated by attending physicians were diagnosed within several hours. In the case of one patient in Group III who died of cardiac tamponade, the outcome was related to the late diagnosis. Prompt and appropriate clinical diagnosis is essential in the management of patients with aortic dissection. In conclusion, practitioners' accuracy is an important factor in treating aortic dissection at emergency room.
