J Korean Soc Emerg Med.  2000 Dec;11(4):516-524.

Clinical Difference Between a Thoracic Aortic Dissection and an Acute Myocardial Infarction

• Kang MH
• Kim KT

Abstract

BACKGROUND: Acute dissection of the thoracic aorta can mimic the symptoms of myocardial infarction with pain, elevated serum creatinine kinase levels, and electrocardiographic abnormalities suggesting myocardial ischemia. Therefore, this study was designed to assess the clinical differences between a thoracic aortic dissection and an acute myocardial infarction.
METHODS
The cases of 72 patients who visited the Emergency Department, Dankook University Hospital, from January 1996 to December 1998 were retrospectively reviewed. Of the 72 patients, 32 were thoracic aortic dissections and 40 were acute myocardial infarctions. The parameters analyzed were epidemiology, pain character and associated symptoms, simple X-rays, EKGs on arrival.
RESULTS
This study demonstrated that 1) there were significant differences in the nature, location, and duration of pain, the radiation, the neurologic symptoms, the chest X-rays, and the EKGs between the two groups and that 2) there were no significant differences in pain severity and abrupt onset.
CONCLUSION
This study suggests that patients with suspected acute myocardial infarction should be provided an appropriate, accurate technique, such as CT, MRI, or TEE, if the nature, location, and duration of pain, the radiation, the neurologic symptoms, the chest X-ray, and the EKG are consistent with a thoracic aortic dissection.

MeSH Terms

Aorta, Thoracic
Creatinine
Electrocardiography
Emergency Service, Hospital
Epidemiology
Humans
Magnetic Resonance Imaging
Myocardial Infarction*
Myocardial Ischemia
Neurologic Manifestations
Phosphotransferases
Retrospective Studies
Thorax
Creatinine
Phosphotransferases