Clinical analysis of suspected acute aortic dissection with ST-segment elevation detected by inferior leads
10.3760/cma.j.issn.1671-0282.2016.07.008
- VernacularTitle:下壁导联 ST 段抬高急性主动脉夹层临床分析
- Author:
Jianbo YU
;
Chang DU
;
Wenfeng HUANG
;
Yunhui MA
;
Guiying DONG
;
Jiaxuan LV
;
Yuanyuan PEI
;
Jihong ZHU
- Publication Type:Journal Article
- Keywords:
ST-segment elevation in inferior leads;
Acute aortic dissection;
Clinical characteristics
- From:
Chinese Journal of Emergency Medicine
2016;25(7):883-886
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical characteristics of suspected acute aortic dissection with ST-segment elevation detected by inferior leads in order to avoid the misdiagnosis of acute aortic dissection facilitating an appropriate treatment strategy carried out in time.Methods A total of 14 patients with suspected acute aortic dissection with ST-segment elevation detected by inferior leads were enrolled.Their clinical presentation,ECG features,imaging findings,laboratory testing,coronary angiography results, treatment and outcome were retrospectively analyzed.Results Clinical characteristics of suspected acute aortic dissection with ST-segment elevation detected by inferior leads suggested that hypertension as a single risk factor accounted for 79%.The patients with normal blood pressure or high blood pressure in emergency visits accounted for 86%.The amplitude of ST elevation in lead Ⅲ was greater than that in lead Ⅱ,and lead Ⅲ accompanied with ST elevation in lead V1 or V4R accounted for 86%.Significantly elevated D-dimer >2 000 ng/mL was found in those patients.Coronary angiography showed that the opening of coronary artery not seen,normal coronary arteries or a simple right coronary artery proximal lesion.Transesophageal echocardiography and computed tomography angiography were used to identify the diagnosis with 100%accuracy.The mortality rate of this group was 50%.Conclusions Patients with acute aortic dissection evidenced by ST-segment elevation detected by inferior leads are in critical setting of high mortality. Emergency surgical treatment can significantly improve the survival rate of patients.
