Believe it or not, someone presents to your ER with chest pain!
.
List 7 different presentations that would make you concerned for an aortic dissection.1. Pain above and below the diaphragm.
2. Chest pain with a neurologic deficit.
3. Tearing pain that radiates to the back.
4. Chest pain with unequal upper extremity blood pressures.
5. Chest pain with a pulseless extremity
6. Chest pain with hematuria
7. Chest pain with history/physical exam concerning for Marfan’s or Ehler’s Danlos, Turner Syndrome, or syphilis! Oddly, be concerned in patients with vasculitis (SLE, giant cell arteritis, rheumatoid arthritis, takayasu arteritis)
Sense of impending doom!
By Dr. Andrew Grock and Dr. Sally Bogoch
References
Rivers
uptodate.com
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