Give an overview about the management.
Determine pretest probability, e.g., based on clinical evaluation and/or aortic dissection detection risk score.
Order initial investigations, e.g., CXR, ECG, laboratory studies.
Concurrently investigate other potential causes of symptoms: See “Chest pain”, “Syncope”, and “Dyspnea.”
Maintain a low threshold to obtain definitive imaging for aortic dissection, e.g., CTA.
Begin therapy based on imaging findings and Stanford classification: See “Treatment.”
Describe the pretest probability.
The following can help determine the likelihood of aortic dissection compared to other life-threatening causes with overlapping features (e.g., MI, stroke, PE).
Red flag features accompanying chest pain: These increase the likelihood of aortic dissection.
Truncal and/or neck pain
Neurological features
Syncope
Acute limb ischemia
Aortic dissection detection risk score (ADD-RS): a bedside clinical tool used to assess the risk of acute aortic dissection based on high-risk conditions, pain, and examination features.
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