Clinical characteristics of aortic aneurysm and dissection as a cause of sudden death in outpatients

Lauren C. Pierce, D. Mark Courtney

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Objective: To describe characteristics of nonhospitalized patients experiencing sudden death from aortic causes and compare with characteristics of patients experiencing nontraumatic, unexpected, outpatient death from other causes. Methods: Retrospective case-control analysis of patients aged 18 to 65 years with nontraumatic, unexpected, outpatient cardiac arrest, emergency department (ED) resuscitation attempts, and autopsy-determined cause of death. Demographics, prodromal symptoms, and arrest characteristics were examined, and univariate comparisons between patients with aortic and those with nonaortic causes of death were performed. Results: A total of 384 patients met inclusion criteria. Aortic pathology represented 4.4% of patients (12 dissections, 5 aneurysms). Preexisting aortic disease (n = 2) and antemortem suspicion of an aortic cause (n = 3) were uncommon. Patients with an aortic cause of death often had prodromal symptoms (53% 95% CI; 28%-77%) and hemopericardium (47% 95% CI; 23%-72%), were older, and were more likely to have a pulse in the ED, an arrest rhythm of pulseless electrical activity, and an arrest witnessed arrest by a medical provider. Conclusion: In this sample of outpatients with cardiac arrest from aortic disease, death was not instantaneous, and hemopericardium was common in many patients with dissection.

Original languageEnglish (US)
Pages (from-to)1042-1046
Number of pages5
JournalAmerican Journal of Emergency Medicine
Volume26
Issue number9
DOIs
StatePublished - Nov 1 2008
Externally publishedYes

ASJC Scopus subject areas

  • Emergency Medicine

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