[Aortic dissection--a differential diagnosis in patients with chest pain and ECG changes].

BACKGROUND

The effect of thrombolytic therapy in patients with myocardial infarction is well documented. In patients presenting with chest pain it may, however, be difficult to discriminate between myocardial infarction and aortic dissection only on the basis of clinical manifestations. Moreover, patients with type A dissection may have ECG changes caused by affection of the coronary flow.

MATERIAL AND

METHODS

We retrospectively investigated all patients admitted to our hospital with type A dissection of the aorta over the period 1999 to March 2001.

RESULTS

Fourteen patients were identified. Only two patients had normal ECG, six had ST elevation. Two patients had received antithrombotic or thrombolytic therapy.

INTERPRETATION: In patients with chest pain and ST elevation, aortic dissection must be considered as a differential diagnosis before thrombolytic therapy.