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Summary

The clinical characteristics of painless aortic dissection were investigated in order to improve the awareness of diagnosis and treatment of atypical aortic dissection. The 482 cases of aortic dissection were divided into painless group and pain group, and the data of the two groups were retrospectively analyzed. The major clinical symptom was pain in 447 cases (92.74%), while 35 patients (7.26%) had no typical pain. The gender, age, hypertension, hyperlipidemia, diabetes, smoking and drinking history had no statistically significant differences between the two groups (P>0.05). The proportion of Stanford type A in painless group was significantly higher than that in pain group (48.57% vs. 21.03%, P=0.006). The incidence of unconsciousness in the painless group was significantly higher than that in the pain group (14.29% vs. 3.58%, P=0.011). The incidence of hypotension in painless group was significantly higher than that in pain group for 4.26 folds (P=0.01). Computed tomography angiography (CTA) examination revealed that the incidence of aortic arch involved in the painless group was significantly higher than that in the pain group (19.23% vs. 5.52%, P=0.019). It was concluded that the incidence of painless aortic dissection was higher in Stanford A type patients, commonly seen in the patients complicated with hypotension and unconsciousness. CTA examination revealed higher incidence of aortic arch involvement.

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References

  1. Lemaire SA, Russell L. Epidemiology of thoracic aortic dissection. Nat Rev Cardiol, 2011,8(2):103–113

    Article  PubMed  Google Scholar 

  2. Menon A, Garg AA, Rai S, et al. Management of acute Type A aortic dissection. Med J Armed Forces India, 2014,70(1):73–75

    Article  CAS  PubMed  Google Scholar 

  3. Hagan PG, Nienaber CA, Isselbacher EM, et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA, 2000,283(7):897–903

    Article  CAS  PubMed  Google Scholar 

  4. Hoskin J, Gardner F. Silent dissection of the aorta. Br Heart J, 1946,8:141–146

    Article  PubMed Central  Google Scholar 

  5. Matsuo H. Clinical significance and impact of “painless” acute aortic dissection. Circ J, 2011,75(1):47–48

    Article  PubMed  Google Scholar 

  6. Park SW, Hutchison S, Mehta RH, et al. Association of painless acute aortic dissection with increased mortality. Mayo Clin Proc, 2004,79(10):1252–1257

    Article  PubMed  Google Scholar 

  7. Imamura H, Sekiguchi Y, Iwashita T, et al. Painless acute aortic dissection. Diagnostic, prognostic and clinical implications. Circ J, 2011,75(1):59–66

    Article  PubMed  Google Scholar 

  8. Stanley I, Sharma VK, Tsivgoulis G, et al. Painless aortic dissection with unusual extension into intracranial internal carotid arteries. Cerebrovasc Dis, 2007,24(2–3):314–315

    Article  PubMed  Google Scholar 

  9. Gaul C, Dietrich W, Friedrich I, et al. Neurological symptoms in type A aortic dissections. Stroke, 2007, 38(2):292–297

    Article  PubMed  Google Scholar 

  10. Yamashiro S, Arakaki R, Kise Y, et al. Emergency operation for aortic dissection with ischemic stroke. Asian Cardiovasc Thorac Ann, 2014,22(2):208–211

    Article  PubMed  Google Scholar 

  11. Morelli N, Rota E, Mancuso M, et al. Carotid ultrasound imaging in a patient with acute ischemic stroke and aortic dissection: a lesson for the management of ischemic stroke? Int J Stroke, 2013,8(8):E53–E54

    Article  CAS  PubMed  Google Scholar 

  12. Lourenco S, Neves Z, Pacheco MH, et al. Painless acute aortic dissection: the challenge of a difficult diagnosis in a patient with heart failure. Med Intensiva, 2011,35(7):446–447

    Article  CAS  PubMed  Google Scholar 

  13. Ko JI, Park T. Headache: a rare manifestation of Debakey type I aortic dissection. Am J Emerg Med, 2014,32(3):291–295

    Article  PubMed  Google Scholar 

  14. Walma RA, Vermeij FH, Bakker S. Neurological signs in aortic dissection. Ned Tijdschr Geneeskd, 2013,157(38):A6259

    PubMed  Google Scholar 

  15. Khan IA, Nair CK. Clinical, diagnostic, and management perspectives of aortic dissection. Chest, 2002,122(1):311–328

    Article  PubMed  Google Scholar 

  16. Karthikesalingam A, Holt PJ, Hinchliffe RJ, et al. The diagnosis and management of aortic dissection. Vasc Endovascular Surg, 2010,44(3):165–169

    Article  CAS  PubMed  Google Scholar 

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Correspondence to He-song Zeng  (曾和松).

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Liu, Zy., Zou, Yl., Chai, Bl. et al. Analysis of clinical features of painless aortic dissection. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 34, 582–585 (2014). https://doi.org/10.1007/s11596-014-1319-8

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  • DOI: https://doi.org/10.1007/s11596-014-1319-8

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