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Diagnosis of a ruptured abdominal aortic aneurysm (rAAA) is challenging, with a wrong diagnosis occurring in between 32 and 42 % of cases. Such errors further increase the mortality risk due to incorrect first response and treatment. In cases of misdiagnosis, aortic rupture is often mistaken for ureteric colic and myocardial infarction (MI). [3]
Thus traumatic aortic rupture is a common killer in automotive accidents and other traumas, [1] with up to 18% of deaths that occur in automobile collisions being related to the injury. [2] In fact, aortic disruption due to blunt chest trauma is the second leading cause of injury death behind traumatic brain injury .
Rupture may be the first sign of AAA. Once an aneurysm has ruptured, it presents with classic symptoms of abdominal pain which is severe, constant, and radiating to the back. [8] The diagnosis of an abdominal aortic aneurysm can be confirmed by the use of ultrasound. Rupture may be indicated by the presence of free fluid in the abdomen.
A ruptured aneurysm typically leads to an aortocardiac shunt and progressively worsening heart failure. [2] An aneurysm of the aortic sinus may rupture due to infective endocarditis involving the aortic wall and tertiary-stage syphilis. [citation needed] The manifestations appear depending on the site where the sinus has ruptured.
A level less than 500 ng/ml may be considered evidence against a diagnosis of aortic dissection, [1] [31] although this guideline is only applicable in cases deemed "low risk" [32] and within 24 hours of symptom onset. [33] The American Heart Association does not advise using this test in making the diagnosis, as evidence is still tentative. [34]
People who are experiencing aortic dissection, meanwhile—a tear in one of the body’s major arteries—describe sudden, stabbing pain in the middle of the chest that radiates to their back ...
As a result, normal blood flow can become slow or stop, and the aorta can rupture. Per the Mayo Clinic, aortic dissection is a "life-threatening condition that requires immediate recognition," and ...
The condition can be mimicked by a ruptured cyst of the pericardium, [11] ruptured aortic aneurysm [10] and acute coronary syndrome. [12] Misdiagnosis is estimated at 39% and is associated with delays correct diagnosis and improper treatment with anticoagulants producing excessive bleeding and extended hospital stays. [12]
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