Takeuchi Shinsuke, Yamaguchi Yoshihiro, Yoshino Hideaki
Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
Eur Heart J Case Rep. 2019 Dec;3(4):1-5. doi: 10.1093/ehjcr/ytz218. Epub 2019 Dec 6.
The prognosis of patients admitted for acute aortic dissection (AAD) has remarkably improved. However, we must also consider out-of-hospital cardiopulmonary arrest (OHCPA) patients while assessing the prognosis. In recent years, autopsy imaging has become more common as an alternative to conventional autopsy. Therefore, we reviewed our OHCPA patients with type A AAD using acute phase non-contrast computed tomography (CT).
Here, we report a case series of three patients who developed OHCPA and were diagnosed with type A AAD using non-contrast CT. Although the direct causes of death varied in each case, we could easily determine the direct causes of death from clinical course of the condition and from non-contrast CT.
Although non-contrast CT does not completely replace autopsy, if its convenience and non-invasiveness make it possible for more patients to undergo the procedure, the real prognosis (including morbidity and mortality) may be better understood. Therefore, we considered it significant to use non-contrast CT for investigating the cause of sudden death.
急性主动脉夹层（AAD）患者的预后有了显著改善。然而，在评估预后时，我们也必须考虑院外心脏骤停（OHCPA）患者。近年来，尸检成像作为传统尸检的替代方法变得越来越普遍。因此，我们使用急性期非增强计算机断层扫描（CT）对我们的A型AAD的OHCPA患者进行了回顾。
在此，我们报告了一组三例发生OHCPA并使用非增强CT诊断为A型AAD的病例系列。尽管每例患者的直接死因各不相同，但我们能够从病情的临床过程和非增强CT中轻松确定直接死因。
尽管非增强CT不能完全替代尸检，但如果其便利性和非侵入性使更多患者能够接受该检查，那么可能会更好地了解真实的预后（包括发病率和死亡率）。因此，我们认为使用非增强CT调查猝死原因具有重要意义。
