Aortic Dissection that Presented to a Tertiary Hospital’s ED in Dubai, UAE: A Descriptive Study with Literature Review

Objectives: Aortic dissection is a life-threatening condition, with a high mortality rate. It can be classified into Stanford type A or type B. This study reports the clinical presentation, risk factors, systolic blood pressure, and the mortality rate of patients with confirmed aortic dissection on computed tomography (CT) imaging. Mortality rate on weekends, weekdays, daytime, and night-time were also reported. Methods: A retrospective review of electronic health records of all patients requiring CT aortogram in the emergency department (ED) between 2013 and 2022 were examined. Patients with confirmed acute aortic dissection on CT were included. Presenting symptoms, demographics, and mortality rate were described and reported for type A and type B aortic dissection. Results: Of 315 patients, 65 had confirmed acute aortic dissection on CT imaging. The mean age at presentation was 50.6 years and the majority of the cohort were male (83%). Chest pain was the most common symptom (43%). A history of hypertension was present in 65% of the subjects. D-dimer was elevated in 95% of the patients. The overall in-hospital mortality was 18.5%, with a mortality rate of 40% in type A aortic dissection. Conclusion: Aortic dissection can occur with various symptoms, and therefore, requires a high index of suspicion. Chest X-ray has a low sensitivity in detecting aortic dissection and should not be used to rule out aortic dissection. D-dimer can be used as a diagnostic assay in ruling out aortic dissection. Type A aortic dissection has the highest mortality rate and hence necessitates prompt intervention.