Clinicopathology of aortic dissection

A population based study was carried out over a 25-year period (1972-1997) to disclose the clinical and pathological features of aortic dissection based on the analysis of 79 (71 acute and 8 chronic) consecutive cases of disease observed in an defined population of 106,000 inhabitants. Of the 79 patients 65 (82.3%) were admitted to hospital and 14 (17.7%) died out of hospital. Their ages ranged from 36 to 97 years (mean, 65.4 yrs), 49 (62.0%) were men and 30 (38.0%) were women with means 61.2 and 69.1 years, respectively. The male/female ration was 1.6:1. All but two operated patients died. The pain was the leading symptom. Every patients had some kind of cardiovascular and respiratory signs. Neurologic symptoms occurred in 27/65 (41.5%) patients. In five patients the clinical picture of abdominal catastrophe and in two patients renal failure occurred. The major vessels were affected in 32/75 (42.7%) autopsies. Aortic rupture were seen in 64/79 (81.0%) cases. Five spontaneous healings were observed. The hypertension, the advantaged age and the arteriosclerosis are regarded as the mean predisposing factors.