ACEPNow - By Anton Helman - November 13, 2017
"Take-Home Points
- Remember the big pain pearls when taking a history:
- Ask the three important questions.
- Aortic dissection should be considered the subarachnoid hemorrhage of the torso.
- Migrating pain, colicky pain, plus need for IV opioids should raise your suspicion.
- Intermittent pain can still be a dissection.
- Look for Marfan syndrome, listen for an aortic regurgitation murmur, and feel for a pulse deficit.
- Think not only about CP +1 but also 1+ CP.
- Know the radiographic findings of loss or aortic knob/aortopulmonary window and the calcium sign, and use POCUS to look for an intimal flap and pericardial effusion.
- Don’t be misled by a troponin or D-dimer."