Diagnosing aortic dissection: A review of this elusive, lethal diagnosis
Abstract Aortic dissection (AD) remains a difficult diagnosis in the emergency setting. Despite its rare occurrence, it is a life‐threatening pathology that, if missed, is typically fatal. Previous studies have documented minimal improvement in timely and accurate diagnoses despite the advancement o...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-08-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.13225 |
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| author | Blake Briggs David Cline |
| author_facet | Blake Briggs David Cline |
| author_sort | Blake Briggs |
| collection | DOAJ |
| description | Abstract Aortic dissection (AD) remains a difficult diagnosis in the emergency setting. Despite its rare occurrence, it is a life‐threatening pathology that, if missed, is typically fatal. Previous studies have documented minimal improvement in timely and accurate diagnoses despite the advancement of computed tomography. Previous literature has highlighted aortic dissections as a major cause of serious misdiagnosis‐related harm. The aim of this article is to review the available literature on AD, discussing the diversity in presentations and the prevalence of historical and exam features to better aid in the diagnosis of AD. AD remains a difficult diagnosis, even with the widespread prevalence of computed tomography angiography usage. No single feature of the history or physical examination is enough to raise suspicion. The diagnosis should be strongly considered in any patient with chest pain that is severe and unexplained by other findings or testing. Those who do not present with acute pain are often complicated by neurologic deficits, hypotension, or syncope. These patients suffer from a change in mental status limiting their ability to participate in the history and physical examination and have a higher rate of complications and mortality. An educated understanding of the atypical presentations of aortic dissection helps the clinician to realistically rank it on the differential diagnosis, culminating in judicious use of definitive imaging. |
| format | Article |
| id | doaj-art-dac7025504f841ff82bb7159814c7268 |
| institution | DOAJ |
| issn | 2688-1152 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-dac7025504f841ff82bb7159814c72682025-08-20T03:06:05ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522024-08-0154n/an/a10.1002/emp2.13225Diagnosing aortic dissection: A review of this elusive, lethal diagnosisBlake Briggs0David Cline1Division of Emergency Medicine Department of Surgery University of Tennessee Graduate School of Medicine Knoxville Tennessee USADepartment of Emergency Medicine Wake Forest University School of Medicine Winston‐Salem North Carolina USAAbstract Aortic dissection (AD) remains a difficult diagnosis in the emergency setting. Despite its rare occurrence, it is a life‐threatening pathology that, if missed, is typically fatal. Previous studies have documented minimal improvement in timely and accurate diagnoses despite the advancement of computed tomography. Previous literature has highlighted aortic dissections as a major cause of serious misdiagnosis‐related harm. The aim of this article is to review the available literature on AD, discussing the diversity in presentations and the prevalence of historical and exam features to better aid in the diagnosis of AD. AD remains a difficult diagnosis, even with the widespread prevalence of computed tomography angiography usage. No single feature of the history or physical examination is enough to raise suspicion. The diagnosis should be strongly considered in any patient with chest pain that is severe and unexplained by other findings or testing. Those who do not present with acute pain are often complicated by neurologic deficits, hypotension, or syncope. These patients suffer from a change in mental status limiting their ability to participate in the history and physical examination and have a higher rate of complications and mortality. An educated understanding of the atypical presentations of aortic dissection helps the clinician to realistically rank it on the differential diagnosis, culminating in judicious use of definitive imaging.https://doi.org/10.1002/emp2.13225aortic dissectiondiagnostic errorsmisdiagnosisultrasonography |
| spellingShingle | Blake Briggs David Cline Diagnosing aortic dissection: A review of this elusive, lethal diagnosis Journal of the American College of Emergency Physicians Open aortic dissection diagnostic errors misdiagnosis ultrasonography |
| title | Diagnosing aortic dissection: A review of this elusive, lethal diagnosis |
| title_full | Diagnosing aortic dissection: A review of this elusive, lethal diagnosis |
| title_fullStr | Diagnosing aortic dissection: A review of this elusive, lethal diagnosis |
| title_full_unstemmed | Diagnosing aortic dissection: A review of this elusive, lethal diagnosis |
| title_short | Diagnosing aortic dissection: A review of this elusive, lethal diagnosis |
| title_sort | diagnosing aortic dissection a review of this elusive lethal diagnosis |
| topic | aortic dissection diagnostic errors misdiagnosis ultrasonography |
| url | https://doi.org/10.1002/emp2.13225 |
| work_keys_str_mv | AT blakebriggs diagnosingaorticdissectionareviewofthiselusivelethaldiagnosis AT davidcline diagnosingaorticdissectionareviewofthiselusivelethaldiagnosis |