Patients with high-risk clinical features are at high risk for acute aortic dissection

April 10, 2018, Society for Academic Emergency Medicine
Aortic dissection: high-risk clinical features. Credit: Kirsty Challen, B.Sc., MBChB, MRes, Ph.D., Lancashire Teaching Hospitals, United Kingdom.

Patients with one or more high-risk clinical features (tearing pain, hypotension, pulse deficit, neurologic deficit, new murmur) should be considered high risk for acute aortic dissection (AAD). That is the finding of a study to be published in the April 2018 issue of Academic Emergency Medicine (AEM), a journal of the Society for Academic Emergency Medicine (SAEM).

The lead author of the study is Dr. Robert Ohle, MSc, MA, MB, FRCPC, Department of Emergency Medicine, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario.

The study by Ohle, et al, further found that patients with no high-risk and multiple low-risk features (absence of abrupt-onset pain, history of ischemic heart disease and diabetes) are at low risk for acute aortic dissection.

A novel finding of the study was that a history of decreased the probability of AAD.

The study suggested that educational strategies focusing on disseminating the diagnostic accuracy of clinical findings could reduce time to diagnosis and that further research should focus on the ability of a combination of these factors in the assessment of a patient for AAD.

The findings support the need for prospective data collection to address the reproducibility of subjective historical features and the accuracy of D-dimer in a lower-risk population.

Lane McNeil Smith, MD, PhD, assistant professor, Lexington Emergency Medicine, Wake Forest Baptist Health, commented:

"Ohle et al have done a great job at telling us how presents to departments. Are we finally on the verge of a decision rule for this disease that improves our miss rate without ballooning non-therapeutic imaging and costs? This study is a step in the right direction and the authors are in a good position to find the right balance of improved accuracy and increased cost."

Explore further: Multidisciplinary approach to identifying and caring for ischemic stroke in young women

More information: Robert Ohle et al, High Risk Clinical Features for Acute Aortic Dissection: A Case-Control Study, Academic Emergency Medicine (2017). DOI: 10.1111/acem.13356

Related Stories

Multidisciplinary approach to identifying and caring for ischemic stroke in young women

December 27, 2017
A multidisciplinary approach aimed at providing emergency physicians with a foundation of knowledge regarding ischemic stroke in young women and addressing the unique challenges in the evaluation and diagnosis of ischemic ...

Simple tool can predict serious adverse events in acute heart failure patients

March 6, 2017
More than one million patients are admitted to the hospital with heart failure each year. A prospective clinical validation found the Ottawa Heart Failure Risk Scale (OHFRS) tool to be highly sensitive for serious adverse ...

Fluoroquinolones linked to increased risk of aortic disease

March 9, 2018
New research from a Swedish and Danish team of researchers led from Karolinska Institutet lend additional support to a link between treatment with fluoroquinolone antibiotics and an increased risk of acute aortic disease. ...

New tool identifies headache patients at risk of aneurysms in emergency department

November 13, 2017
A new tool to identify potentially fatal aneurysms in patients with headaches who seem otherwise well will help emergency departments to identify high-risk patients, improve survival rates and cut out unnecessary imaging, ...

Rule could take one-third of chest pain patients off emergency department heart monitors

January 30, 2017
Ottawa researchers have validated a rule that could safely take a third of chest pain patients in the emergency department off of heart monitors, according to a study published in the Canadian Medical Association Journal. ...

Higher acute aortic dissection risk with lower-volume care

May 13, 2013
(HealthDay)—The mortality risk from emergency repair of acute aortic dissection is double when performed by lower-volume providers, according to research published in the May issue of the Annals of Thoracic Surgery.

Recommended for you

Bypass beats stents for diabetics with heart trouble: study

November 13, 2018
(HealthDay)—People with both diabetes and multiple clogged heart arteries live longer if they undergo bypass surgery rather than have their blood vessels reopened with stents, according to follow-up results from a landmark ...

Kawasaki disease: One disease, multiple triggers

November 12, 2018
Researchers at University of California San Diego School of Medicine, Scripps Institution of Oceanography, and international collaborators have evidence that Kawasaki Disease (KD) does not have a single cause. By studying ...

New treatment significantly reduces cardiovascular events when combined with statins

November 12, 2018
Statins are the most commonly used treatment for cardiovascular disease. Despite reducing certain risk factors, if triglyceride levels remain high with use of statins, there is still a significant risk for heart attack, stroke ...

Study: How vitamin D and fish oil affect risk of heart attack, stroke and cancer

November 12, 2018
For years, it's remained an open question: What effects do dietary supplements such as high doses of vitamin D or omega-3 fatty acids derived from fish oil have on the risk of diseases such as heart attack, stroke and cancer? ...

Diabetes drug might also ease heart failure risks

November 12, 2018
(HealthDay)—The diabetes drug Farxiga might do double-duty for patients, helping to ward off another killer, heart failure, new research shows.

Updated cholesterol guidelines offer more personalized risk assessment, additional treatment options

November 12, 2018
More personalized risk assessments and new cholesterol-lowering drug options for people at the highest risk for cardiovascular disease (CVD) are among the key recommendations in the 2018 cholesterol guidelines from the American ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.