Clinical profile of patients of acute aortic dissection presenting to the ED without chest pain

A report based on patients collected in the International Registry of Acute Aortic Dissection (IRAD) between 1997 and 2001 found that 6.4% of cases of AAD were painless and had a higher in-hospital mortality. Eligible patients were searched in the hospital database that had a principal diagnosis code (International Classification of Disease version 9) between 440.99 and 441.91 on hospital discharge. Ischemic ECG changes were defined as new ST elevation or depression, T wave inversion and Q waves. There was no significant difference between patients with and without chest pain regarding risk factors (male gender, older age, underlying Marfan syndrome, aortic valve disease or surgery, and hypertension) of AAD. (Table 1) For clinical presentation (Table 2), more patients in the group who did not have chest pain were considered non-urgent at triage, although there was no significant difference in comparison to the group with chest pain. 2006 emergency department summary, National health statistics reports; no 7, 2008, National Center for Health Statistics, Hyattsville, MD 3 M. Kurabayashi, N. Miwa, D. Ueshima, K. Sugiyama, K. Yoshimura, T. Shimura, Factors leading to failure to diagnose acute aortic dissection in the emergency room, J Cardiol, Vol. 58, 2011, 287-293 4 M. Chua, I. Ibrahim, X. Neo, V. Sorokin, L. Shen, S. Ooi, Acute aortic dissection in the ED: risk factors and predictors for missed diagnosis, Am J Emerg Med, Vol. 30, 2012, 1622-1626 5 P.G.N.C. Hagan, E.M. Isselbacher, D. Bruckman, D.J. Karavite, P.L. Russman, The international registry of acute aortic dissection: new insights...