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
The views expressed on this blog are the author's own and do not reflect the views of their employer. Please read our full disclaimer here. Any references to clinical cases refer to patients treated at a virtual hospital, Janus General Hospital.
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andygrock
- Resident Editor In Chief of blog.clinicalmonster.com.
- Co-Founder and Co-Director of the ALiEM AIR Executive Board - Check it out here: http://www.aliem.com/aliem-approved-instructional-resources-air-series/
- Resident at Kings County Hospital
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