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J Korean Soc Emerg Med > Volume 11(4); 2000 > Article
Journal of The Korean Society of Emergency Medicine 2000;11(4): 516-524.
Clinical Difference Between a Thoracic Aortic Dissection and an Acute Myocardial Infarction
Myeong Hee Kang, Kab Teug Kim
ABSTRACT
BACKGROUND: Acute dissection of the thoracic aorta can mimic the symptoms of myocardial infarction with pain, elevated serum creatinine kinase levels, and electrocardiographic abnormalities suggesting myocardial ischemia. Therefore, this study was designed to assess the clinical differences between a thoracic aortic dissection and an acute myocardial infarction.
METHODS:
The cases of 72 patients who visited the Emergency Department, Dankook University Hospital, from January 1996 to December 1998 were retrospectively reviewed. Of the 72 patients, 32 were thoracic aortic dissections and 40 were acute myocardial infarctions. The parameters analyzed were epidemiology, pain character and associated symptoms, simple X-rays, EKGs on arrival.
RESULTS:
This study demonstrated that 1) there were significant differences in the nature, location, and duration of pain, the radiation, the neurologic symptoms, the chest X-rays, and the EKGs between the two groups and that 2) there were no significant differences in pain severity and abrupt onset.
CONCLUSION:
This study suggests that patients with suspected acute myocardial infarction should be provided an appropriate, accurate technique, such as CT, MRI, or TEE, if the nature, location, and duration of pain, the radiation, the neurologic symptoms, the chest X-ray, and the EKG are consistent with a thoracic aortic dissection.
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