The characteristics of acute aortic dissection among young chinese patients

A comparison between Marfan syndrome and non-Marfan syndrome patients

Shih Hung Tsai, Yen Yue Lin, Chin-Wung Hsu, Yu Long Chen, Min Tser Liao, Shu Jye Chu

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: Aortic dissection (AoD) is one of the most common catastrophes involving the aorta. Nevertheless, early diagnosis remains to be a challenge in the Emergency Department (ED), particularly in young individuals. In this study, we attempted to identify the characteristics of acute AoD among young individuals, particular in patients with Marfan syndrome. Materials and Methods: This was an retrospective chart-review study conducted in a tertiary referring hospital. The hospital database was queried for the combination of AoD and patients under age of 40 years. The medical charts were reviewed to obtain demographic data, clinical data and laboratory characteristics by using a standardized data collection sheet. A comparison between Marfan syndrome and non-Marfan syndrome patients was performed. Results: During the 10-years period, 18 of 344 patients with acute AoD were younger than 40 years-old. Patients with Marfan syndrome developed acute AoD at a younger age than patients without Marfan syndrome. The mean diastolic blood pressure was significantly lower in patients with Marfan syndrome upon presenting to the ED than those without. Patients with Marfan syndrome had trends toward higher risk of development of type A AoD, increased recurrence rate and higher mortality rate than those without. However, statistical significance was not present. Conclusion: ED physicians should have high alert to acute AoD in young patients presenting with severe unexplained chest and back pain, particularly in those patients with a history of heart diseases, hypertension, and Marfan syndrome or featuring Marfanoid habitus. Acute coronary syndrome, unexplained abdominal symptoms, and sudden cardiac arrest could be the initial manifestation of AoD in young patients. A low threshold to perform enhanced computed tomography may facilitate early diagnosis and timely treatment in this patient population.

Original languageEnglish
Pages (from-to)239-244
Number of pages6
JournalYonsei Medical Journal
Volume50
Issue number2
DOIs
Publication statusPublished - 2009
Externally publishedYes

Fingerprint

Marfan Syndrome
Dissection
Hospital Emergency Service
Early Diagnosis
Blood Pressure
Sudden Cardiac Death
Back Pain
Acute Coronary Syndrome
Chest Pain
Tertiary Care Centers
Aorta
Heart Diseases

Keywords

  • Aortic dissection
  • Congenital heart disease
  • Hypertension
  • Marfan syndrome
  • Young age

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The characteristics of acute aortic dissection among young chinese patients : A comparison between Marfan syndrome and non-Marfan syndrome patients. / Tsai, Shih Hung; Lin, Yen Yue; Hsu, Chin-Wung; Chen, Yu Long; Liao, Min Tser; Chu, Shu Jye.

In: Yonsei Medical Journal, Vol. 50, No. 2, 2009, p. 239-244.

Research output: Contribution to journalArticle

Tsai, Shih Hung ; Lin, Yen Yue ; Hsu, Chin-Wung ; Chen, Yu Long ; Liao, Min Tser ; Chu, Shu Jye. / The characteristics of acute aortic dissection among young chinese patients : A comparison between Marfan syndrome and non-Marfan syndrome patients. In: Yonsei Medical Journal. 2009 ; Vol. 50, No. 2. pp. 239-244.
@article{2554b009f0854032bf23e112fd138b1f,
title = "The characteristics of acute aortic dissection among young chinese patients: A comparison between Marfan syndrome and non-Marfan syndrome patients",
abstract = "Purpose: Aortic dissection (AoD) is one of the most common catastrophes involving the aorta. Nevertheless, early diagnosis remains to be a challenge in the Emergency Department (ED), particularly in young individuals. In this study, we attempted to identify the characteristics of acute AoD among young individuals, particular in patients with Marfan syndrome. Materials and Methods: This was an retrospective chart-review study conducted in a tertiary referring hospital. The hospital database was queried for the combination of AoD and patients under age of 40 years. The medical charts were reviewed to obtain demographic data, clinical data and laboratory characteristics by using a standardized data collection sheet. A comparison between Marfan syndrome and non-Marfan syndrome patients was performed. Results: During the 10-years period, 18 of 344 patients with acute AoD were younger than 40 years-old. Patients with Marfan syndrome developed acute AoD at a younger age than patients without Marfan syndrome. The mean diastolic blood pressure was significantly lower in patients with Marfan syndrome upon presenting to the ED than those without. Patients with Marfan syndrome had trends toward higher risk of development of type A AoD, increased recurrence rate and higher mortality rate than those without. However, statistical significance was not present. Conclusion: ED physicians should have high alert to acute AoD in young patients presenting with severe unexplained chest and back pain, particularly in those patients with a history of heart diseases, hypertension, and Marfan syndrome or featuring Marfanoid habitus. Acute coronary syndrome, unexplained abdominal symptoms, and sudden cardiac arrest could be the initial manifestation of AoD in young patients. A low threshold to perform enhanced computed tomography may facilitate early diagnosis and timely treatment in this patient population.",
keywords = "Aortic dissection, Congenital heart disease, Hypertension, Marfan syndrome, Young age",
author = "Tsai, {Shih Hung} and Lin, {Yen Yue} and Chin-Wung Hsu and Chen, {Yu Long} and Liao, {Min Tser} and Chu, {Shu Jye}",
year = "2009",
doi = "10.3349/ymj.2009.50.2.239",
language = "English",
volume = "50",
pages = "239--244",
journal = "Yonsei Medical Journal",
issn = "0513-5796",
publisher = "Yonsei University College of Medicine",
number = "2",

}

TY - JOUR

T1 - The characteristics of acute aortic dissection among young chinese patients

T2 - A comparison between Marfan syndrome and non-Marfan syndrome patients

AU - Tsai, Shih Hung

AU - Lin, Yen Yue

AU - Hsu, Chin-Wung

AU - Chen, Yu Long

AU - Liao, Min Tser

AU - Chu, Shu Jye

PY - 2009

Y1 - 2009

N2 - Purpose: Aortic dissection (AoD) is one of the most common catastrophes involving the aorta. Nevertheless, early diagnosis remains to be a challenge in the Emergency Department (ED), particularly in young individuals. In this study, we attempted to identify the characteristics of acute AoD among young individuals, particular in patients with Marfan syndrome. Materials and Methods: This was an retrospective chart-review study conducted in a tertiary referring hospital. The hospital database was queried for the combination of AoD and patients under age of 40 years. The medical charts were reviewed to obtain demographic data, clinical data and laboratory characteristics by using a standardized data collection sheet. A comparison between Marfan syndrome and non-Marfan syndrome patients was performed. Results: During the 10-years period, 18 of 344 patients with acute AoD were younger than 40 years-old. Patients with Marfan syndrome developed acute AoD at a younger age than patients without Marfan syndrome. The mean diastolic blood pressure was significantly lower in patients with Marfan syndrome upon presenting to the ED than those without. Patients with Marfan syndrome had trends toward higher risk of development of type A AoD, increased recurrence rate and higher mortality rate than those without. However, statistical significance was not present. Conclusion: ED physicians should have high alert to acute AoD in young patients presenting with severe unexplained chest and back pain, particularly in those patients with a history of heart diseases, hypertension, and Marfan syndrome or featuring Marfanoid habitus. Acute coronary syndrome, unexplained abdominal symptoms, and sudden cardiac arrest could be the initial manifestation of AoD in young patients. A low threshold to perform enhanced computed tomography may facilitate early diagnosis and timely treatment in this patient population.

AB - Purpose: Aortic dissection (AoD) is one of the most common catastrophes involving the aorta. Nevertheless, early diagnosis remains to be a challenge in the Emergency Department (ED), particularly in young individuals. In this study, we attempted to identify the characteristics of acute AoD among young individuals, particular in patients with Marfan syndrome. Materials and Methods: This was an retrospective chart-review study conducted in a tertiary referring hospital. The hospital database was queried for the combination of AoD and patients under age of 40 years. The medical charts were reviewed to obtain demographic data, clinical data and laboratory characteristics by using a standardized data collection sheet. A comparison between Marfan syndrome and non-Marfan syndrome patients was performed. Results: During the 10-years period, 18 of 344 patients with acute AoD were younger than 40 years-old. Patients with Marfan syndrome developed acute AoD at a younger age than patients without Marfan syndrome. The mean diastolic blood pressure was significantly lower in patients with Marfan syndrome upon presenting to the ED than those without. Patients with Marfan syndrome had trends toward higher risk of development of type A AoD, increased recurrence rate and higher mortality rate than those without. However, statistical significance was not present. Conclusion: ED physicians should have high alert to acute AoD in young patients presenting with severe unexplained chest and back pain, particularly in those patients with a history of heart diseases, hypertension, and Marfan syndrome or featuring Marfanoid habitus. Acute coronary syndrome, unexplained abdominal symptoms, and sudden cardiac arrest could be the initial manifestation of AoD in young patients. A low threshold to perform enhanced computed tomography may facilitate early diagnosis and timely treatment in this patient population.

KW - Aortic dissection

KW - Congenital heart disease

KW - Hypertension

KW - Marfan syndrome

KW - Young age

UR - http://www.scopus.com/inward/record.url?scp=66549128690&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=66549128690&partnerID=8YFLogxK

U2 - 10.3349/ymj.2009.50.2.239

DO - 10.3349/ymj.2009.50.2.239

M3 - Article

VL - 50

SP - 239

EP - 244

JO - Yonsei Medical Journal

JF - Yonsei Medical Journal

SN - 0513-5796

IS - 2

ER -