Emergency Medicine Cases - February 2017 - By Anton Helman
"Take Home Points for Aortic Dissection Diagnosis and Management
- Remember the big pain pearls when taking a history: The 3 important questions, aortic dissection is the subarachnoid hemorrhage of the torso, migrating pain, colicky pain + opioids = badness and pain that comes and goes can still be a dissection.
- Look for Marphan’s, listen for an aortic regurgitation murmur and feel for a pulse deficit.
- Think not only about CP +1 but also 1+ CP
- Know the CXR findings of loss or aortic knob/aortopulmonary window and the calcium sign, use POCUS to look for an intimal flap and pericardial effusion
- Don’t be misled by a positive troponin
- When it comes to management, treat pain first, then HR and then BP"