Aortic dissection diagnostic study of choice: Difference between revisions

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===Clinical Criteria===
===Clinical Criteria===
==2014 ESC Guidelines on the Diagnosis and Treatment of Aortic Diseases (DO NOT EDIT)<ref name="pmid25173340">{{cite journal |vauthors=Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, Evangelista A, Falk V, Frank H, Gaemperli O, Grabenwöger M, Haverich A, Iung B, Manolis AJ, Meijboom F, Nienaber CA, Roffi M, Rousseau H, Sechtem U, Sirnes PA, Allmen RS, Vrints CJ |title=2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC) |journal=Eur. Heart J. |volume=35 |issue=41 |pages=2873–926 |date=November 2014 |pmid=25173340 |doi=10.1093/eurheartj/ehu281 |url=}}</ref>==
==2014 ESC Guidelines on the Diagnosis and Treatment of Aortic Diseases (DO NOT EDIT)==
===Risk Stratification of Patients Suspicious for Aortic Dissection<ref name="HiratzkaBakris2010">{{cite journal|last1=Hiratzka|first1=Loren F.|last2=Bakris|first2=George L.|last3=Beckman|first3=Joshua A.|last4=Bersin|first4=Robert M.|last5=Carr|first5=Vincent F.|last6=Casey|first6=Donald E.|last7=Eagle|first7=Kim A.|last8=Hermann|first8=Luke K.|last9=Isselbacher|first9=Eric M.|last10=Kazerooni|first10=Ella A.|last11=Kouchoukos|first11=Nicholas T.|last12=Lytle|first12=Bruce W.|last13=Milewicz|first13=Dianna M.|last14=Reich|first14=David L.|last15=Sen|first15=Souvik|last16=Shinn|first16=Julie A.|last17=Svensson|first17=Lars G.|last18=Williams|first18=David M.|title=2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease|journal=Circulation|volume=121|issue=13|year=2010|issn=0009-7322|doi=10.1161/CIR.0b013e3181d4739e}}</ref>===
===Risk Stratification of Patients Suspicious for Aortic Dissection===
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* Connective tissue disorders including Marfan syndrome
*[[Connective tissue disorder]]<nowiki/>s including [[Marfan syndrome]]
| rowspan="5"  style="background: #F5F5F5; padding: 5px;" align="center"|'''1'''
| rowspan="5"  style="background: #F5F5F5; padding: 5px;" align="center"|'''1'''
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* Family history of aortic disease
* Family history of [[aortic disease]]
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| style="background: #F5F5F5; padding: 5px;" |
* Personal history aortic valve disease
* Personal history [[aortic valve disease]]
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* Personal history of thoracic aortic aneurysm
* Personal history of [[thoracic aortic aneurysm]]
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| style="background: #F5F5F5; padding: 5px;" |
* Previous aortic surgery (including cardiac surgery)
* Previous [[aortic]] surgery (including [[cardiac surgery]])
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* Chest, back, or abdominal pain with at least one of the following features:
*[[Chest pain|Chest]], [[Back pain|back]], or [[abdominal pain]] with at least one of the following features:
** Abrupt onset
** Abrupt onset
** Severe intensity
** Severe intensity
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* Evidence of insufficient blood supply:
* Evidence of insufficient blood supply:
** Absent pulse
**[[Absent pulse]]
** Systolic blood pressure difference
** Systolic blood pressure difference
** Focal neurological deficit (along with pain)
** Focal neurological deficit (along with pain)
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* Hypotension or shock
*[[Hypotension]] or [[shock]]
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Revision as of 17:20, 10 December 2019

Aortic dissection Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Aortic dissection from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Special Scenarios

Management during Pregnancy

Case Studies

Case #1


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]

Overview

Diagnostic Study of Choice

Clinical Criteria

2014 ESC Guidelines on the Diagnosis and Treatment of Aortic Diseases (DO NOT EDIT)

Risk Stratification of Patients Suspicious for Aortic Dissection

High Risk Conditions Score
1
High Risk Pain Characteristics Score
  • Chest, back, or abdominal pain with at least one of the following features:
    • Abrupt onset
    • Severe intensity
    • Ripping or tearing
 1
High Risk Physical Findings Score
  • Evidence of insufficient blood supply:
    • Absent pulse
    • Systolic blood pressure difference
    • Focal neurological deficit (along with pain)
 1
  • Aortic diastolic murmur (new and with pain)

Comparison of Various Diagnostic Modalities for the Diagnosis of Aortic Dissection (DO NOT EDIT)[1]

Location Diagnostic Modality Diagnostic Value
Ascending Aortic Dissection
  • Transthoracic Echocardiography
  • Moderate
  • Transoesophageal Echocardiography
  • Excellent
  • CT Scan
  • Excellent
  • MRI
  • Excellent
Aortic Arch Dissection
  • Transthoracic Echocardiography
  • Poor
  • Transoesophageal Echocardiography
  • Poor
  • CT Scan
  • Excellent
  • MRI
  • Excellent
Descending Aortic Dissection
  • Transthoracic Echocardiography
  • Poor
  • Transoesophageal Echocardiography
  • Excellent
  • CT Scan
  • Excellent
  • MRI
  • Excellent

Diagnostic Work-up of Patients Suspicious of Acute Aortic Syndrome with Unstable Hemodynamic[1]

Class I
"(Level of Evidence: B)"
Class IIb
"(Level of Evidence: C)"

Diagnostic Work-up of Patients Suspicious of Acute Aortic Syndrome with Stable Hemodynamic[1]

Class I
"(Level of Evidence: B)"
Class IIb
"(Level of Evidence: C)"

References

  1. ↑ 1.0 1.1 1.2 Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, Evangelista A, Falk V, Frank H, Gaemperli O, Grabenwöger M, Haverich A, Iung B, Manolis AJ, Meijboom F, Nienaber CA, Roffi M, Rousseau H, Sechtem U, Sirnes PA, Allmen RS, Vrints CJ (November 2014). "2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC)". Eur. Heart J. 35 (41): 2873–926. doi:10.1093/eurheartj/ehu281. PMID 25173340.
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