Sensitivity of the Aortic Dissection Detection Risk Score, a Novel Guideline-Based Tool for Identification of Acute Aortic Dissection at Initial Presentation

Rogers, Adam M.; Hermann, Luke; Booher, Anna M.; Nienaber, Christoph; Williams, David M.; Kazerooni, Ella A.; Froehlich, James B.; O’Gara, Patrick T.; Montgomery, Daniel; Cooper, Jeanna V.; Harris, Kevin M.; Hutchison, Stuart J.; Evangelista, Arturo; Isselbacher, Eric M.; Eagle, Kim A.

doi:10.1161/circulationaha.110.988568

Cited by 283 publications

(191 citation statements)

References 13 publications

(1 reference statement)

Supporting

Mentioning

160

Contrasting

Unclassified

Order By: Relevance

“…Large pleural effusions resulting from aortic bleeding into the mediastinum and pleural space are rare because these patients usually do not survive up to their arrival at the hospital [15].…”

Section: Pleural Effusionsmentioning

confidence: 99%

“…If D-dimers are elevated, the suspicion of AAD is increased [15][16][17]. Typically, the level of D-dimers is immediately very high, compared with other disorders in which the D-dimer level increases gradually.…”

Section: Laboratory Testingmentioning

confidence: 99%

“…Typically, the level of D-dimers is immediately very high, compared with other disorders in which the D-dimer level increases gradually. D-dimers yielded the highest diagnostic value during the first hour If the D-dimers are negative, Intramural Hematoma (IH) and Penetrating Aortic Ulcer (PAU) may still be present; however, the advantage of the test is the increased alert for the differential diagnosis [15].…”

Section: Laboratory Testingmentioning

confidence: 99%

See 2 more Smart Citations

Warning at emergency room: The role of diagnostic test in acute aortic dissection

Lagi¹

2017

Vascul Dis Ther

View full text Add to dashboard Cite

show abstract

Section: Pleural Effusionsmentioning

confidence: 99%

Section: Laboratory Testingmentioning

confidence: 99%

Section: Laboratory Testingmentioning

confidence: 99%

See 1 more Smart Citation

Warning at emergency room: The role of diagnostic test in acute aortic dissection

Lagi¹

2017

Vascul Dis Ther

View full text Add to dashboard Cite

show abstract

“…The diagnosis of AD can be made on transverse CT images, but multi-planar reconstruction images play an important complementary role in confirming the diagnosis and determining the extent of involvement, especially with regard to involvement of aortic branch vessels. The major role of multi-detector CT is in providing specific, precise measurements of the extent of the dissection, including length and diameter of the aorta, the true lumen (TL), the false lumen (FL), involvement of vital vasculature and the distance from the intimal tear to the vital vascular branches (10).…”

Section: Ctmentioning

confidence: 99%

Differential aspects of the disease and treatment of Thoracic Acute Aortic Dissection (TAAD)—the European experience

Pepper

2016

Ann. Cardiothorac. Surg.

View full text Add to dashboard Cite

show abstract

“…Patients can be divided to 3 groups: low, intermediate, and high risk based on historical and examination. The ADD risk score has a 95.7% of sensitivity, while its specificity has not been documented (19).…”

mentioning

confidence: 99%

A case of ascending aortic dissection mimicking acute myocardial infarction and complicated with pericardial tamponade

Hawatmeh

Arqoub

Isbitan

et al. 2016

Cardiovasc. Diagn. Ther.

View full text Add to dashboard Cite

A 60-year-old male with past medical history of hypertension, presented to emergency department complaining of chest pain for 2 hours, the pain was described as tearing, substernal pain and was radiating to the neck and shoulders and associated with nausea and sweating. Initial vital signs showed Blood pressure of 120/90 mmHg in right arm, and 110/70 mmHg in left arm, Heart rate of 90 beat per minute, Respiratory rate was 18 breath per minute, temperature of 37.6 ℃ and Oxygen saturation of 95% breathing ambient air. Physical exam was significant for jugular venous distension and cardiac exam showed normal heart sounds, an early diastolic murmur, 3/6 in intensity, best heard on left 3 rd intercostal space without radiation, and no S3 or S4 gallop. Initial lab results showed a white blood cell count of 8.1 k/μL, hemoglobin of 12.2 g/dL, platelets of 177 k/μL, creatinine of 1.19 mg/dL, AST of 30 IU/L, ALT of 29 IU/L, initial set of troponin I was 0.02 ng/mL. Twelve lead electrocardiogram (EKG) showed ST segment elevations in inferior leads ( Figure 1). Emergent coronary angiography was done and revealed normal coronary arteries without evidence of dissection ( Figure 2). After the catheter was pulled back across the aortic valve, an aortic root angiogram was performed and showed aortic insufficiency (grade 3), and an aortic dissection flap that started in the ascending aorta and progressed through to the descending aorta ( Figure 3); this was classified as a Stanford type A (DeBakey type I). A bedside transthoracic echocardiogram was also performed after cardiac catheterization, and showed an EF of 40 % with inferior wall hypokinesia, a dilated aortic root with an evidence of intimal tear in the ascending aorta and moderate aortic regurgitation. In addition, mild pericardial effusion was also noted.Vascular surgery team was immediately consulted, and an aortic computed tomography (CT) scan was done and revealed a Stanford type A (DeBakey type I) aortic Abstract: Acute aortic dissection (AD) is the most common life-threatening disorder affecting the aorta with an incidence that ranges between 5 to 30 cases per million people per year. The symptoms of aortic dissection may be variable and can mimic other more common conditions such as myocardial ischemia. We report a case of a 60-year-old male who presented with inferior wall ST-elevation myocardial infarction (MI).Emergent coronary angiography revealed an ascending aortic dissection with normal coronary arteries. In addition, his aortic dissection was complicated with pericardial tamponade. The patient was managed with an immediate surgical repair, after that he had an uncomplicated postoperative course and was discharged in a stable condition. This case report illustrates the importance of having a high index of suspicion for AD in cases of chest pain. If AD is suspected in a patient with acute coronary syndrome (ACS), confirming the diagnosis with the appropriate imaging studies should be done as quickly as possible, as misdiagnosis with ACS may lead to the inappr...

show abstract

Sensitivity of the Aortic Dissection Detection Risk Score, a Novel Guideline-Based Tool for Identification of Acute Aortic Dissection at Initial Presentation

Cited by 283 publications

References 13 publications

Warning at emergency room: The role of diagnostic test in acute aortic dissection

Warning at emergency room: The role of diagnostic test in acute aortic dissection

Differential aspects of the disease and treatment of Thoracic Acute Aortic Dissection (TAAD)—the European experience

A case of ascending aortic dissection mimicking acute myocardial infarction and complicated with pericardial tamponade

Contact Info

Product

Resources

About