Not typical misdiagnosis of 22 cases of aortic dissection.doc

 PAGE \* MERGEFORMAT 7 Not typical misdiagnosis of 22 cases of aortic dissection Author: Liu Jiangru, Su Yufang, Pan Yanping [Words] are not typical misdiagnosis of aortic dissection Retrospective analysis of 2000 -2008 admitted 22 patients with aortic dissection (AD) misdiagnosed the patient’s clinical data of the clinical features, in order to improve the clinical diagnosis and treatment of this disease, to reduce the misdiagnosis rate. 1 Clinical data 1.1 General Information The group of 22 patients, 14 males and 8 females, aged 32 to 78 years. There is a clear history of hypertension in 13 cases, 3 patients with a history of diabetes, has a long history of alcohol abuse in 2 cases. According to DeBakey type: Ⅰ type 10 cases, Ⅱ type 4 cases, Ⅲ in 8 cases. 1.2 Clinical manifestations Complex and diverse clinical manifestations. First symptoms manifested as sudden chest, back, waist, abdomen and other parts of the severe pain, was like a knife or tearing, unbearable, the most common 14 cases of chest pain in patients with chest pain, accounting for 63.6 %, followed by pleural effusion, a total of 11 cases, accounting for 50% of other clinical manifestations include: disturbance of consciousness, dizziness, limb movement disorder, shortness of breath. shock can occur in some patients. cardiac auscultation area diastolic murmur of aortic four cases , gallop, 2 cases of bilateral asymmetry in blood pressure and pulse in 3 cases. only 1 patients without obvious symptoms, physical examination found incidentally. 1.3 auxiliary examination ECG: normal ECG in 6 cases, non-specific ST T segment changes in 8 cases, 7 cases of left ventricular hypertrophy, 6 cases of acute myocardial infarction graphics chest X-ray: 18 cases showed mediastinal shadow widened, widened aortic shadow extension. Heart ultrasound: A total of 14 cases of cardiac ultrasound examination, 6 patients with mild to moderate aortic valve regurgitation, 2 cases small, the