Clinical studyChest radiography for the diagnosis of acute aortic syndrome
Section snippets
Patients
During a 6-year period, 216 patients (143 men and 73 women; mean [± SD] age, 58 ± 17 years) presented to the emergency department of the University Hospital of Hamburg-Eppendorf with suspected acute aortic disease. All patients had onset of chest pain, back pain, or both, within 14 days of arrival at the emergency department. Patients with the acute coronary syndrome or other diagnoses explaining the pain syndrome, recent trauma, or cardiovascular surgery, or who could not provide a history,
Results
Of the 216 patients, aortic dissection was diagnosed in 57 patients, nondissecting aneurysm was diagnosed in 36 patients (with contained rupture in 3 of them), and intramural hemorrhage or penetrating aortic ulcer was diagnosed in 16 patients; aortic disease was excluded in the remaining 107 patients (Table 1). A consensus decision on the presence or absence of aortic disease on chest radiography was obtained for all patients. Aortic disease was diagnosed by chest radiography with a
Discussion
This study, with blinded expert evaluation, was designed to assess the diagnostic accuracy of chest radiography among patients with suspected acute aortic syndrome. Previous studies of chest radiography assessed its value for diagnosing aortic dissection only. The 11 reports from studies that included at least 50 cases (a total of 1398 patients) had an overall sensitivity of 71% 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11. For the broader diagnosis of the acute coronary syndrome, our study had an overall
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