Differentiating ATAAD from ST-elevation myocardial infarction

Authors

Wayne T. Dewri, University of LynchburgFollow

Specialty

Emergency Medicine

Advisor

Dr. Laura Witte

Abstract

Due to the rarity of the incidence and elusive nature of the disease, the diagnosis of acute non-traumatic Type A aortic dissection (ATAAD) is suspected at initial evaluation in fewer than half of the patients ultimately diagnosed with aortic dissection (AD) in the Emergency Department (ED).Additionally, the clinical presentation of ATAAD and ST- elevation myocardial infarction (STEMI) may be quite similar, including changes in the electrocardiogram (ECG), and chest radiograph may be normal in up to 20% of the cases.

It is imperative that clinicians working in the acute care setting remain vigilant and consider ATAAD a top differential diagnosis in adult patients with chest pain. This is because the therapeutic interventions for STEMI is contraindicated in ATAAD.The high- risk scores established by the American Heart Association (AHA) associated with ATAAD based on underlined comorbidities, clinical symptoms, physical examination and diagnostic findings, along with proper clinical and diagnostic workup will help to discriminate ATAAD from a STEMI, voiding detrimental outcomes.

Recommended Citation

Dewri WT. Differentiating ATAAD from ST-elevation myocardial infarction. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2021; 4(1).