Need of investigation
According to a clinical prediction rule of the American Medical Association, symptoms that best determine the risk of acute aortic dissection in patients with acute chest pain, acute back pain, or both are:
- Pain in the chest or abdomen with immediate onset and a tearing or ripping character
- Differentials in pulse (absence of a proximal extremity or carotid pulse) and/or blood pressure (>20 mmHg difference between the right and left arm)
- Mediastinal and/or aortic widening on chest radiography
Probability of dissection was found to be relatively low (7%) only in the absence of all 3 variables.
Choice of modality
- Hemodynamically stable patients without suspected ascending aortic involvement, CT of aortic dissection is generally the initial imaging method of choice.
- For hemodynamically unstable patients or where a dissection of the ascending aorta is suspected, transesophageal echocardiography (TEE) is suggested as the first investigation of choice.
- For a full list of contributors, see article Radlines:Authorship for details. . Creators of images are attributed at the image description pages, seen by clicking on the images. See
- von Kodolitsch, Yskert; Schwartz, Ann G.; Nienaber, Christoph A. (2000). "Clinical Prediction of Acute Aortic Dissection ". Archives of Internal Medicine 160 (19): 2977. doi:10.1001/archinte.160.19.2977. ISSN 0003-9926.
- James H Black, III, Warren J Manning. Clinical features and diagnosis of acute aortic dissection. UpToDate. This topic last updated: Feb 16, 2018. Topic 8190 Version 29.0}}