Background/aim: Acute aortic dissection (AAD) is a rare but fatal disease if left untreated. Symptoms are often similar to common conditions; therefore, the diagnostic strategy is important. We aimed to identify the atypical symptoms in a timely manner without putting patients at greater risk for undetected AAD.Materials and methods: We conducted a retrospective observational study of 59 AAD patients with both atypical and typical symptoms from January 2012 to December 2016. Patients with atypical symptoms continuing more than 30 min underwent a D-dimer test and computed tomography (CT) or computed tomographic angiography (CTA).Results: Of the 59 AAD patients, 22 were atypical. In the atypical group, the median delay time in our hospital was 3.1 h; average delay time after July 2015 was shorter than average delay time before June 2015 (16.59 ± 24.70 vs. 1.90 ± 0.57 h, P = 0.076).Conclusions: For patients in the emergency department who are suspected of having AAD, incorporating atypical symptoms with high levels of D-dimer into a triage strategy could improve the efficiency of clinical decision making. Furthermore, essential education directed towards the recognition of the atypical symptoms of AAD for front-line physicians may aid in a timely diagnosis, as compared with the usual assessments in the emergency department.
Acute aortic dissection, atypical symptoms, assessment, diagnosis, D-dimer, computed tomography, computed tomographic angiography
JIANG, YOUJIN; ZHANG, ZHENGFANG; GU, ZHIMING; ZOU, HENGDI; FAN, WENHUI; CHEN, XIAOJUN; and WANG, HONGYOU
"Timely identification of atypical acute aortic dissection in the emergency department:a study from a tertiary hospital,"
Turkish Journal of Medical Sciences: Vol. 49:
5, Article 8.
Available at: https://journals.tubitak.gov.tr/medical/vol49/iss5/8