Aortic dissection in routine practice
Authors:
J. Vondrák; P. Vojtíšek
Authors place of work:
Kardiologické oddělení
; Primář: MUDr. Petr Vojtíšek, CSc.
; Pardubická krajská nemocnice a. s., Pardubice
Published in the journal:
Prakt. Lék. 2015; 95(3): 100-105
Category:
Of different specialties
Summary
Aim:
To obtain information about the progress and results of treatment of aortic dissection in the present.
Methods:
We performed a retrospective analysis of 38 patients with aortic dissection who were hospitalized in our department for the last 10 years, from 2003 until the end of 2012.
Results:
There were 22 patients with type A aortic dissection according to the Stanford classification, with type B dissections 16. The age in both groups was similar 65 or 66 years, males predominated over women. Arterial hypertension clearly dominated of the risk factors in both groups. In one case we recorded an iatrogenic cause. Our patients most often presented with chest pain, in the second group with backache and stomachache as well. Precordial murmur was dominated in physical finding in the first group, while most patients in the second group had no physical findings. Pulse deficits were a rare find. The computed tomography was the most used diagnostic method. Level of D-dimer was high on average, but we recorded low values in patients with symptoms lasting longer than 24 hours. Complications associated with aortic dissection were more common in the first group. 18 patients of 38 died (47%). There were 22 patients who underwent surgery or interventional procedures with 30-day mortality 32%, which was at the time a downward trend.
Conclusion:
Aortic dissection is currently associated with an acceptable operating decreasing mortality. The predominant clinical sign is sudden pain. The preferred diagnostic method is CT aortography. The recommended biochemical marker is plasma levels of D-dimer with a cutoff value of > 500 ng/ml. A negative value does not exclude aortic dissection.
Keywords:
aortic dissection – Stanford classification – surgery – mortality – conservative approach
Zdroje
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Štítky
General practitioner for children and adolescents General practitioner for adultsČlánok vyšiel v časopise
General Practitioner
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