Tolefac Paul Nkemtendong, Dzudie Anastase, Mouliom Sidick, Aminde Leopold, Hentchoya Romuald, Abanda Martin H, Mvondo Charles Mve, Wanko Vanina D, Luma Henry N
Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon. Email:
Cardiac Intensive Care Unit, Douala General Hospital, Douala Cameroon.
Cardiovasc J Afr. 2018;29(1):e9-e13. doi: 10.5830/CVJA-2017-042. Epub 2017 Nov 3.
Acute aortic dissection is the most frequent and deadly presentation of acute aortic syndromes. Its incidence is estimated at three to four cases per 100 000 persons per year. Its clinical presentation may be misleading, with misdiagnosis ranging between 14.1 and 38% in many series. A late diagnosis or absence of early and appropriate management is associated with mortality rates as high as 50 and 80% by the third day and second week, respectively, especially in proximal lesions. We report on the case of a 53-year-old man who presented with type A aortic dissection, misdiagnosed as acute myocardial infarction, who later died on day 12 of hospitalisation. Although a relatively rare condition, poor awareness in Africa probably accounted for the initial misdiagnosis. Thorough investigation of acute chest pain and initiation of clinical registries are potential avenues to curb related morbidity and mortality.
急性主动脉夹层是急性主动脉综合征最常见且致命的表现形式。其发病率估计为每年每10万人中有3至4例。其临床表现可能具有误导性，在许多系列研究中误诊率在14.1%至38%之间。晚期诊断或缺乏早期适当治疗与死亡率相关，在第三天和第二周时死亡率分别高达50%和80%，尤其是在近端病变中。我们报告了一例53岁男性患者，他表现为A型主动脉夹层，最初被误诊为急性心肌梗死，最终在住院第12天死亡。尽管这是一种相对罕见的疾病，但非洲地区对此认识不足可能是最初误诊的原因。对急性胸痛进行全面检查并启动临床登记是降低相关发病率和死亡率的潜在途径。
