Yusuf YÜRÜMEZ, Yücel YAVUZ, Cuma YILDIRIM, İbrahim İKİZCELİ, Nurullah GÜNAY, Levent AVŞAROĞULLARI, Erdoğan M. SÖZÜER

Analysis of acute aortic diseases newly diagnosed in an emergency department

Amac: Acil doktorları genellikle akut aort hastalığı semptomları olan hastaları ilk değerlendiren doktorlardır ve bu yüzden de mortalite ve morbiditeyi önlemede önemli bir pozisyondadırlar. Bu calışmanın amacı acil serviste yeni tanı alan akut aort hastalığının tanısal parametrelerini ve klinik bulgularını analiz etmektir. Metod: Bu geriye dönük çalışma 1 Ocak 1998 ve 31 Aralık 2001 tarihleri arasında acil servise başvurup yeni tanı konulan akut aort hastalığı olan 24 hastayı kapsamaktadır. Hastaların demografik bulguları, klinik bilgileri, laboratuar ve radyolojik dökümanları ve diğer bilgileri hastane arşivinden elde edildi. Bulgular: Dört yıl süresince akut aort hastalığı olarak tanı alan 24 hastanın da dosyalarına ulaşılabildi. Ortalama yaş 58,2 (29-85) idi. Acil servise hastaların en sık başvuru sebebi gögüs ve/veya sırt ağrısı (%62,5) idi. On hasta (%41,7) önceden hipertansiyon tanısı almıştı. En sık görülen EKG bulgusu ST-T değişikliğiydi (%20,8). Mediastinal genişleme akciğer grafisinde on hastada (%41,7) görüldü. On dört hastada anevrizma (%58,3), altı hastada (%25,0) disseksiyon ve dört hastada (%18,2) dissekan anevrizma tespit edildi. Sonuç: Akut aort hastalıklarının tanısı bir acil servis için son derece önemlidir. Yanlış veya gecikmiş tanı yüksek oranda morbidite ve mortalite ile sonuçlanabilir. Eger acil servisteki bir hastada karın veya göğüs ağrısı mevcut ise akut aort hastalıkları ve onun komplikasyonları mutlaka değerlendirilmelidir.

Acil serviste yeni tanı konmuş akut aort hastalığı olan hastaların analizi

Purpose: Emergency physicians are frequently the initial physicians to evaluate patients with symptoms of acute aortic diseases and therefore they are in a unique position to prevent morbidity and mortality through an early diagnosis. The aim of this retrospective study is to analyze diagnostic parameters and clinical findings in patients with acute aortic diseases newly diagnosed in an emergency department. Methods: This retrospective study includes 24 patients with acute aortic diseases admitted to an emergency department between January 1, 1998, and December 31, 2001. The patients' demographic findings, clinical information, laboratory and radiographic documents, and other information were obtained from the hospital archives. Results: The charts of 24 patients diagnosed with acute aortic disease during the four-year period were obtained. The median age was 58.2 years (range, 29-85). Chest and/or back pain was the most frequent symptom bringing the patients to the emergency department (62.5%). Ten patients (41.7%) had had a prior diagnosis of hypertension. The most frequent electrocardiographs findings were ST-T changes (20.8%). Mediastinal widening was seen in the chesfx-rays of 10 patients (41.7%). Fourteen patients (58.3%) with aneurysm, six patients (25.0%) with dissection and four patients (18.2%) with dissecting aneurysm were detected. Conclusion: The diagnosis ofAAD is of utmost importance for an emergency department. A missed or delayed diagnosis may result in high mortality and morbidity. If a patient with abdominal or thoracic pain is admitted to an emergency department, acute aortic diseases or their complications must be investigated.

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