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Saturday, November 18, 2017

Aortic Dissection

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ACEPNow - By Anton Helman - November 13, 2017
Living Art Enterprises / Science Source
"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."