Thoracic aortic disease risk factors

ACC/AHA Guidelines - Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease (DO NOT EDIT)

Class I Recommendations for Estimation of Pretest Risk of Thoracic Aortic Dissection

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1. Providers should routinely evaluate any patient presenting with complaints that may represent acute thoracic aortic dissection to establish a pretest risk of disease that can then be used to guide diagnostic decisions. This process should include specific questions about medical history, family history, and pain features as well as a focused examination to identify findings that are associated with aortic dissection, including: a. High-risk conditions and historical features (Level of Evidence: B): Marfan syndrome, Loeys-Dietz syndrome, vascular Ehlers-Danlos syndrome, Turner syndrome, or other connective tissue disease. Patients with mutations in genes known to predispose to thoracic aortic aneurysms and dissection, such as FBN1, TGFBR1, TGFBR2, ACTA2, and MYH11. Family history of aortic dissection or thoracic aortic aneurysm. Known aortic valve disease. Recent aortic manipulation (surgical or catheter-based). Known thoracic aortic aneurysm. b. High-risk chest, back, or abdominal pain features(Level of Evidence: B): Pain that is abrupt or instantaneous in onset. Pain that is severe in intensity. Pain that has a ripping, tearing, stabbing, or sharp quality. c. High-risk examination features (Level of Evidence: B): Pulse deficit. Systolic blood pressure limb differential greater than 20 mm Hg. Focal neurologic deficit. Murmur of aortic regurgitation (new).

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