Abstract: the article presents data from a series of 11 cases of fatal dissection of an aortic aneurysm for analyzing the causes of inefficiency of diagnostic measures and developing an algorithm for practical differential diagnosis of this pathology. The article notes the frequency of occurrence of dissecting aortic aneurysm, the frequency of diagnosis confirmation during pathological studies, the percentage of mortality on the first day, week, month and year from the onset of the first symptoms of pathology. The etiology features, pathogenesis and leading factors of the formation of dissection of the ascending aorta and its arch are described, variants of clinical manifestation and complications of aortic dissection are described. The data from a series of clinical cases include patient complaints at the time of admission, anamnesis, results of an objective examination, laboratory findings (general and biochemical blood tests, general urinalysis, coagulogram) and instrumental diagnostic methods (electrocardiography, computed tomography, chest and abdominal radiography, echocardiography), information on the dynamics of patients in the intensive care unit, as well as the results of pathological diagnostics. The main errors of the diagnostic search that substantiated the irrationality of further therapeutic tactics were determined. In this regard, in order to simplify the diagnostic search at the stage of receiving rests a volume of studies with the highest diagnostic value in the first hours from the onset of the disease was proposed. A checklist was developed that includes data for early estimation of the possibility of acute aortic syndrome and a further algorithm of instrumental and laboratory diagnostics, which allows to verify or exclude finally the presence of a dissecting aortic aneurysm and to assess the degree and severity of damage in real conditions of clinical practice.
Keywords: stratified aortic aneurysm, mortality, diagnosis, errors, algorithm