Objective To investigate the clinical characteristics,differential diagnosis,causes of misdiagnosis and preventive measures of aortic dissection(AD)misdiagnosed as acute myocardial infarction(AMI).Methods The clinical data of 8 patients with AD misdiagnosed as AMI were analyzed retrospectively combined with the literature at home and a-broad.Results All 8 patients were males,and 6 had history of hypertension.Chest pain was the main symptom,D-dimer was significantly elevated,and ECG showed significant ST-T changes.Five patients were misdiagnosed as acute ST-segment elevation myocardial infarction(STEMI)and 3 as acute non-STEMI.The mean duration of misdiagnosis was 11 h.All 8 pa-tients were diagnosed with AD by CT angiography of aorta after ineffective AMI-related treatment.Corresponding treatment was provided.After treatment,3 patients improved and 5 died.Conclusion When the main symptom of AD is acute chest pain with ECG ST-T changes,it is more likely to be misdiagnosed as AMI.Clinician should be vigilant,pay attention to the differ-ential diagnosis of the above two diseases,conduct detailed consultation and careful physical examination,and take effective imaging examinations as soon as possible to reduce or avoid misdiagnosis and mistreatment of AD.
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