Morris Jacqueline H, Mix Doran, Cameron Scott J
Division of Cardiology, Department of Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 679, Rochester, NY, 14642, USA.
Division of Vascular Surgery, Department of Surgery, University of Rochester School of Medicine, Box CVRI, Rochester, NY, 14642, USA.
Curr Treat Options Cardiovasc Med. 2017 Apr;19(4):29. doi: 10.1007/s11936-017-0523-9.
Advances in medical therapy and non-surgical percutaneous options to manage the specter of acute aortic syndromes have improved both patient morbidity and mortality. There are key features in the patient history and initial exam which physicians should be attuned to in order to diagnose acute aortic syndromes such as aortic dissection, penetrating aortic ulcer, and intramural hematoma. Once recognized, early initiation of the appropriate pharmacologic therapy is important, and further appreciating the limitations of such therapy before considering a surgical approach is critical to improve patient outcomes. For the undifferentiated patient with acute aortic dissection presenting to facilities who do not routinely manage this condition, adding pharmacologic agents in the correct sequence assures the best chance for a satisfactory outcome.
医学治疗以及用于处理急性主动脉综合征的非手术经皮治疗方法的进展，已改善了患者的发病率和死亡率。患者病史和初始检查中有一些关键特征，医生应予以关注，以便诊断急性主动脉综合征，如主动脉夹层、穿透性主动脉溃疡和壁内血肿。一旦确诊，尽早开始适当的药物治疗很重要，并且在考虑手术治疗之前进一步认识到这种治疗的局限性，对于改善患者预后至关重要。对于未分化的急性主动脉夹层患者，如果就诊的医疗机构不常规处理这种情况，按正确顺序添加药物可确保获得满意结果的最佳机会。
