Aortic dissection in children and young adults: Diagnosis, patients at risk, and outcomes

Eli Zalzstein, Robert Hamilton, Nili Zucker, Samuel Diamant, Gary Webb

    Research output: Contribution to journalArticlepeer-review

    54 Scopus citations

    Abstract

    Objective: To heighten the awareness of pediatricians and pediatric cardiologists to aortic dissection, a potentially dangerous medical condition. Methods: We reviewed the charts of 13 patients, seen in four medical centers, who suffered acute or chronic aortic dissection over the period 1970 through 2000 whilst under the age of 25 years. Results: There were seven male and six female patients, with the mean age at diagnosis being 12.1 years, with a range from one day to 25 years. Congenital cardiac defects were present in five patients, and Marfan syndrome in four. In three of the patients with congenital cardiac defects, aortic dissection developed as a complication of medical procedures. In three patients, dissection followed blunt trauma to the chest. We could not identify any risk factors in one patient. The presenting symptoms included chest pain in four patients, abdominal pain and signs of ischemic bowel in two, non-palpable femoral pulses in one, and obstruction of the superior caval vein in one. Angiography and magnetic resonance imaging were the main diagnostic tools. Overall mortality was 38%. Only six patients had successful surgical outcomes. Conclusion: Due to the rarity of aortic dissection a high index of suspicion is required to reach the diagnosis in a timely manner. It should be considered in young patients complaining of chest pain in association with Marfan syndrome, anomalies of the aortic valve and arch, and chest trauma.

    Original languageEnglish
    Pages (from-to)341-344
    Number of pages4
    JournalCardiology in the Young
    Volume13
    Issue number4
    DOIs
    StatePublished - 1 Aug 2003

    Keywords

    • Aortic aneurysm
    • Chest trauma
    • Marfan syndrome

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Cardiology and Cardiovascular Medicine

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