BACKGROUND: Not only symptoms but electrocardiographic (ECG) changes mimicking acute coronary syndrome as well have been known to develop in acute aortic dissection (AAD). However, detailed information is lacking. OBJECTIVE: We sought to evaluate incidence, patterns, and underlying mechanisms for acute ECG changes in type A AAD. METHODS: Retrospective study in a single tertiary care hospital. A total of 159 cases (mean age 65.1±14.8 years, male/female=67/92) that presented within 12 h from the onset were included. Shift of the ST segment ≥0.1 mV or changes of the T wave were considered acute ECG changes. RESULTS: Acute and chronic ECG changes were observed in 49.7% and 36.5% cases, respectively. ECG was normal only in 27.0% cases. ST elevation was observed in 8.2% cases and was closely related to direct coronary involvement. ST depression and T wave changes were observed in 34.0% and 21.4% cases, respectively. Cases with ST depression or T wave changes had higher incidence of shock (65.2% vs. 28.8%, p<0.001) and cardiac tamponade (51.2% vs. 15.0%, p<0.001) compared with those without changes. CONCLUSION: Acute ECG changes were common in type A AAD. Physicians taking care of patients with chest pain and acute ECG changes should consider the possibility of AAD before performing thrombolysis or percutaneous catheter intervention.
BACKGROUND: Not only symptoms but electrocardiographic (ECG) changes mimicking acute coronary syndrome as well have been known to develop in acute aortic dissection (AAD). However, detailed information is lacking. OBJECTIVE: We sought to evaluate incidence, patterns, and underlying mechanisms for acute ECG changes in type A AAD. METHODS: Retrospective study in a single tertiary care hospital. A total of 159 cases (mean age 65.1±14.8 years, male/female=67/92) that presented within 12 h from the onset were included. Shift of the ST segment ≥0.1 mV or changes of the T wave were considered acute ECG changes. RESULTS: Acute and chronic ECG changes were observed in 49.7% and 36.5% cases, respectively. ECG was normal only in 27.0% cases. ST elevation was observed in 8.2% cases and was closely related to direct coronary involvement. ST depression and T wave changes were observed in 34.0% and 21.4% cases, respectively. Cases with ST depression or T wave changes had higher incidence of shock (65.2% vs. 28.8%, p<0.001) and cardiac tamponade (51.2% vs. 15.0%, p<0.001) compared with those without changes. CONCLUSION: Acute ECG changes were common in type A AAD. Physicians taking care of patients with chest pain and acute ECG changes should consider the possibility of AAD before performing thrombolysis or percutaneous catheter intervention.
Authors: Jip L Tolenaar; Stuart J Hutchison; Dan Montgomery; Patrick O'Gara; Rosella Fattori; Reed E Pyeritz; Linda Pape; Toru Suzuki; Arturo Evangelista; Frans L Moll; Vincenzo Rampoldi; Eric M Isselbacher; Cristoph A Nienaber; Kim A Eagle; Santi Trimarchi Journal: Aorta (Stamford) Date: 2013-07-01
Authors: Valeria Guglielmi; Nina-Suzanne Groeneveld; Laura Posthuma; Adrien E Groot; Charles Blm Majoie; Hanna Talacua; Abdullah Kaya; S Matthijs Boekholdt; R Nils Planken; Yvo Bwem Roos; Jonathan M Coutinho Journal: Eur Stroke J Date: 2019-10-22