AORTIC DISSECTION RED FLAGS FOR EMERGENCY TRIAGE STAFF FIRST RESPONDERS
RED FLAGS FOR
EMERGENCY TRIAGE STAFF
A patient with an aortic dissection may not appear to be a “typical” chest pain patient – he or she
may be younger, tall/thin, and have no known risk factors for heart disease.
Approximately 10,000 people experience aortic dissections annually, so it is likely that emergency
first responders will encounter this condition. 50% of patients with undiagnosed aortic dissection die
with 48 hours, a death rate of approximately 1% per hour. Dissections of the aortic root and
ascending aorta require immediate surgical intervention.
As a result, it is extremely important that emergency first responders are prepared to evaluate
symptoms that could be related to a dissection and expedite emergency treatment.
About aortic dissection
An aortic dissection is a tear in the inner layer of the aortic wall. This tear allows blood to enter and
separate the inner and outer layers of the vessel. In addition, dissection can weaken the outer wall,
resulting in instability or rupture; occlusion (blockage) of aortic branch vessels causing myocardial
infarction, stroke, kidney failure, bowel ischemia, paraplegia or limb ischemia; and disruption of the
aortic valve, resulting in valvular insufficiency and congestive heart failure.
Who is at risk?
Risk factors for thoracic aortic disease, aneurysm, and dissection include certain genetic connective
tissue disorders, a family history of thoracic aortic aneurysm/dissection, bicuspid aortic valve,
uncontrolled hypertension, heavy weight lifting, trauma to the aorta, and certain inflammatory
diseases (Takayasu arteritis, giant cell arteritis, Behçet disease, ankylosing spondylitis).
There are genetic syndromes that affect multiple organ systems, including the skeleton, lungs, eyes,
heart, and increase the risk for aortic dissections. Genetic syndromes that increase the risk for aortic
• Familial Thoracic Aortic Aneurysms and Dissections
• Marfan Syndrome
• Loeys-Dietz Syndrome
• Ehlers-Dantos Syndrome-Vascular Type
• Turner Syndrome
• Bicuspid Aortic Valve