Herz

, Volume 38, Issue 3, pp 269–276 | Cite as

Diagnosis of acute aortic syndromes

Imaging and beyond
Review article

Abstract

Acute aortic syndromes are fatal medical conditions including classic acute aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer. Given the nonspecific symptoms and signs, a high clinical index of suspicion followed by an imaging study, namely transesophageal echocardiography, computed tomography, and magnetic resonance imaging (sensitivity 98–100% and specificity 95–100%), is a conditio sine qua non for prompt diagnosis of acute aortic syndromes. This article provides an overview of established and emerging approaches for the assessment of acute aortic syndromes, with focus on imaging and biomarkers. In this regard, D-dimer levels (cut-off: 500 ng/ml) may be useful to rule out aortic dissection, if used within the first 24 h after symptom onset.

Keywords

Acute aortic syndromes Aortic dissection Cardiac imaging techniques D-dimer Congenital abnormalities 

Diagnose des akuten Aortensyndroms

Bildgebung und mehr

Zusammenfassung

Das akute Aortensyndrom ist eine letale Erkrankung und umfasst beispielsweise die klassische akute Aortendissektion, das intramurale Hämatom und das penetrierende atherosklerotische Ulkus. Angesichts der unspezifischen Symptome sind bei starkem klinischem Verdacht bildgebende Untersuchungen, also transösophageale Echokardiographie, Computertomographie und Magnetresonanztomographie (Sensitivität: 98–100%, Spezifität: 95–100%), eine Conditio sine qua non für die zügige Diagnose eines akuten Aortensyndroms. In der vorliegenden Übersichtsarbeit wird ein Überblick über etablierte und neue Ansätze zur Beurteilung des akuten Aortensyndroms gegeben, dabei liegt der Schwerpunkt auf Bildgebung und Biomarkern. Diesbezüglich ist möglicherweise die Bestimmung des D-Dimer-Spiegels (Grenzwert: 500 ng/ml) zum Ausschluss einer Aortendissektion hilfreich, wenn sie innerhalb der ersten 24 h nach Symptombeginn durchgeführt wird.

Schlüsselwörter

Akutes Aortensyndrom Aortendissektion Kardiale Bildgebungsverfahren D-Dimer Kongenitale Anomalien 

Notes

Acknowledgments

All authors participated in the writing of this manuscript and are responsible for its content. Eduardo Bossone assumes responsibility for the integrity of all contents of this manuscript.

Sources of funding

This work was supported by the National Institutes of Health (NIIH/NHLBI US Federal Government Contract N-01-HV-68199 [National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions]; JWW, KAE) (K23 HL102249-01; JWW).

Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Copyright information

© Urban & Vogel 2012

Authors and Affiliations

  • E. Bossone
    • 1
    • 2
  • T. Suzuki
    • 3
  • K.A. Eagle
    • 4
  • J.W. Weinsaft
    • 5
  1. 1.Heart DepartmentUniversity of SalernoSalernItaly
  2. 2.Cardiac Surgery DepartmentIRCCS Policlinico San Donato, San Donato MilaneseMilanItaly
  3. 3.Department of Cardiovascular Medicine, Graduate School of MedicineThe University of TokyoTokyoJapan
  4. 4.University of Michigan Cardiovascular CenterAnn ArborUSA
  5. 5.Department of MedicineWeill Cornell Medical CollegeNew YorkUSA

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