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  • Writer's pictureShaun Nicosia

AORTIC DISSECTION RED FLAGS FOR EMERGENCY TRIAGE STAFF FIRST RESPONDERS

AORTIC DISSECTION

RED FLAGS FOR

EMERGENCY TRIAGE STAFF

FIRST RESPONDERS

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

dissection include:

• Familial Thoracic Aortic Aneurysms and Dissections

• Marfan Syndrome

• Loeys-Dietz Syndrome

• Ehlers-Dantos Syndrome-Vascular Type

• Turner Syndrome

• Bicuspid Aortic Valve

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