Clinical-epidemiological profile of patients with acute aortic syndromes treated at a reference hospital in Pará
DOI:
https://doi.org/10.33448/rsd-v13i2.45043Keywords:
Dissection; General surgery; Diseases’s prevention; Sepsis.Abstract
Objective: To describe the clinical and epidemiological profile of patients diagnosed with acute aortic syndromes in a cardiovascular reference service in the city of Belém – Pará. Methodology: This is a descriptive study of 12 patients admitted to the Hospital de Clínicas Gaspar Vianna, in the period from March to December 2023. Variables related to age, sex, education, origin, symptoms on admission, characteristic of pain on admission, presence of pulses in the upper and lower limbs, type of aortic syndrome, Stanford and DeBakey classification, were considered. whether surgery was necessary, comorbidities, complications, length of stay and outcomes. Results: Chest pain was present in all patients in the sample and most of them were sudden. There was a pulse in the upper and lower limbs. The most common type of aortic syndrome was acute dissection. Stanford's A rating was the most frequent. In the DeBakey classification there was a greater proportion of classes I and III. Among the participants, 07 required surgery, and the most frequent was Bentall. Among the comorbidities mentioned, SAH had the highest proportion. Sepsis was the most frequent complication, followed by AKI, Hematesis and DHE. Conclusion: Half of the patients had death as an outcome. More studies are needed about this pathology, as well as greater prevention of the disease's risk factors to promote continued education for emergency and first aid teams in order to reduce deaths and complications in patients diagnosed with this syndrome.
References
An, K. R., De Mestral, C., Tam, D. Y., Qiu, F., Ouzounian, M., Lindsay, T. F., Wijeysundera, H. C., & Chung, J. C.-Y. (2021). Surveillance imaging following acute type a aortic dissection. Journal of the American College of Cardiology, 78(19), 1863–1871. https://doi.org/10.1016/j.jacc.2021.08.058.
Bossone, E., LaBounty, T. M., & Eagle, K. A. (2018). Acute aortic syndromes: Diagnosis and management, an update. European Heart Journal, 39(9), 739–749d. https://doi.org/10.1093/eurheartj/ehx319.
Carrel, T., Sundt, T. M., Von Kodolitsch, Y., & Czerny, M. (2023). Acute aortic dissection. The Lancet, 401(10378), 773–788. https://doi.org/10.1016/S0140-6736(22)01970-5.
Coelho Da Silva, A. C., Capcelea, A., Redondeiro, A. I., & Nogueira, E. (2023). Quando um mal nunca vem só! - Relato de um caso de aneurisma e dissecção aórtica concomitantes. Revista Portuguesa de Hipertensão e Risco Cardiovascular, 38-42 Páginas. https://doi.org/10.58043/RPHRC.69
Erbel, R., Aboyans, V., Boileau, C., Bossone, E., Bartolomeo, R. D., Eggebrecht, H., Evangelista, A., Falk, V., Frank, H., Gaemperli, O., Grabenwöger, M., Haverich, A., Iung, B., Manolis, A. J., Meijboom, F., Nienaber, C. A., Roffi, M., Rousseau, H., Sechtem, U. (2014). ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (Esc). European Heart Journal, 35(41), 2873–2926. https://doi.org/10.1093/eurheartj/ehu281.
Estrela, C. (2018). Metodologia científica: ciência, ensino, pesquisa. (3a ed.), Artes Médicas, 2018. 707 p.
Ganapathi, A. M., Ranney, D. N., Peterson, M. D., Lindsay, M. E., Patel, H. J., Pyeritz, R. E., Trimarchi, S., Hutchison, S., Harris, K. M., Greason, K. L., Ota, T., Montgomery, D. G., Nienaber, C. A., Eagle, K. A., Isselbacher, E. M., & Hughes, G. C. (2022). Location of aortic enlargement and risk of type a dissection at smaller diameters. Journal of the American College of Cardiology, 79(19), 1890–1897. https://doi.org/10.1016/j.jacc.2022.02.053.
Gawinecka, J., Schnrath, F., & Von Eckardstein, A. (2017). Acute aortic dissection: Pathogenesis, risk factors and diagnosis. Swiss Medical Weekly. https://doi.org/10.4414/smw.2017.14489.
Harris, K. M., Strauss, C. E., Eagle, K. A., Hirsch, A. T., Isselbacher, E. M., Tsai, T. T., Shiran, H., Fattori, R., Evangelista, A., Cooper, J. V., Montgomery, D. G., Froehlich, J. B., Nienaber, C. A., & for the International Registry of Acute Aortic Dissection (IRAD) Investigators. (2011). Correlates of delayed recognition and treatment of acute type a aortic dissection: The international registry of acute aortic dissection(Irad). Circulation, 124(18), 1911–1918. https://doi.org/10.1161/CIRCULATIONAHA.110.006320.
Isselbacher, E. M., Preventza, O., Hamilton Black, J., Augoustides, J. G., Beck, A. W., Bolen, M. A., Braverman, A. C., Bray, B. E., Brown-Zimmerman, M. M., Chen, E. P., Collins, T. J., DeAnda, A., Fanola, C. L., Girardi, L. N., Hicks, C. W., Hui, D. S., Schuyler Jones, W., Kalahasti, V., Kim, K. M., & Santos Volgman, A. (2022). 2022 acc/aha guideline for the diagnosis and management of aortic disease: A report of the american heart association/american college of cardiology joint committee on clinical practice guidelines. Circulation, 146(24). https://doi.org/10.1161/CIR.0000000000001106.
Maitusong, B., Sun, H.-P., Xielifu, D., Mahemuti, M., Ma, X., Liu, F., Xie, X., Azhati, A., Zhou, X.-R., & Ma, Y.-T. (2016). Sex-related differences between patients with symptomatic acute aortic dissection. Medicine, 95(11), e3100. https://doi.org/10.1097/MD.0000000000003100.
Morello, F., Santoro, M., Fargion, A. T., Grifoni, S., & Nazerian, P. (2021). Diagnosis and management of acute aortic syndromes in the emergency department. Internal and Emergency Medicine, 16(1), 171–181. https://doi.org/10.1007/s11739-020-02354-8.
Nazerian, P., Mueller, C., Vanni, S., Soeiro, A. D. M., Leidel, B. A., Cerini, G., Lupia, E., Palazzo, A., Grifoni, S., & Morello, F. (2019). Integration of transthoracic focused cardiac ultrasound in the diagnostic algorithm for suspected acute aortic syndromes. European Heart Journal, 40(24), 1952–1960. https://doi.org/10.1093/eurheartj/ehz207.
Oderich, G. S., Kärkkäinen, J. M., Reed, N. R., Tenorio, E. R., & Sandri, G. A. (2019). Penetrating aortic ulcer and intramural hematoma. CardioVascular and Interventional Radiology, 42(3), 321–334. https://doi.org/10.1007/s00270-018-2114-x.
Reis, J. M. C. D., Santos, D. R. D., Torres, I. O., & De Luccia, N. (2021). Vascular surgery in the most populous state in the Amazon: Socio-professional profile and aspirations of the specialty. Jornal Vascular Brasileiro, 20, e20210039. https://doi.org/10.1590/1677-5449.210039.
Rogers, R. K., Reece, T. B., Bonaca, M. P., & Hess, C. N. (2021). Acute aortic syndromes. Cardiology Clinics, 39(4), 495–503. https://doi.org/10.1016/j.ccl.2021.06.002.
Rybicki, F. J., Udelson, J. E., Peacock, W. F., Goldhaber, S. Z., Isselbacher, E. M., Kazerooni, E., Kontos, M. C., Litt, H., & Woodard, P. K. (2016). 2015 acr/acc/aha/aats/acep/asnc/nasci/saem/scct/scmr/scpc/snmmi/str/sts appropriate utilization of cardiovascular imaging in emergency department patients with chest pain. Journal of the American College of Cardiology, 67(7), 853–879. https://doi.org/10.1016/j.jacc.2015.09.011.
Shiga, T., Wajima, Z., Apfel, C. C., Inoue, T., & Ohe, Y. (2006). Diagnostic accuracy of transesophageal echocardiography, helical computed tomography, and magnetic resonance imaging for suspected thoracic aortic dissection: Systematic review and meta-analysis. Archives of Internal Medicine, 166(13), 1350. https://doi.org/10.1001/archinte.166.13.1350.
Sibinga Mulder, B. G., Van Strijen, M. J. L., & Heijmen, R. H. (2022). Unexpected, complete recovery after emergent thoracic endovascular aortic repair for inoperable type A aortic dissection. Journal of Vascular Surgery Cases, Innovations and Techniques, 8(2), 167–170. https://doi.org/10.1016/j.jvscit.2022.01.012.
Tadros, R. O., Tang, G. H. L., Barnes, H. J., Mousavi, I., Kovacic, J. C., Faries, P., Olin, J. W., Marin, M. L., & Adams, D. H. (2019). Optimal treatment of uncomplicated type b aortic dissection. Journal of the American College of Cardiology, 74(11), 1494–1504. https://doi.org/10.1016/j.jacc.2019.07.063.
Vignaraja, V., Thapar, A., & Dindyal, S. (2024). Acute aortic syndrome. Em StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK576402/.
Vilacosta, I., San Román, J. A., Di Bartolomeo, R., Eagle, K., Estrera, A. L., Ferrera, C., Kaji, S., Nienaber, C. A., Riambau, V., Schäfers, H.-J., Serrano, F. J., Song, J.-K., & Maroto, L. (2021). Acute aortic syndrome revisited. Journal of the American College of Cardiology, 78(21), 2106–2125. https://doi.org/10.1016/j.jacc.2021.09.022.
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