Clinical Case Database / Category: Clinical Care

The dissecting aorta

Publication details

Dr Adrian Spiteri MD FRCS Ed (A&E) FCEM, Dr Ruth Brown FRCS FCEM
Foundation Years Journal, volume 7, issue 2, p.43 (123Doc Education, London, February 2013)


Aortic dissection is a rare vascular emergency with very high mortality if left untreated, thus needing rapid assessment and resuscitation with early involvement of high level care teams. Patients are usually acutely unwell at presentation, but a proportion of patients have vague and atypical symptoms and signs, making diagnosis diffiult and liable to error. Aortic dissection should be part of the differential diagnosis of any patient with chest, abdominal and back pain. It may also present in an atypical manner such as with syncope, abnormal neurological signs, congestive heart failure and respiratory or gastrointestinal bleeding. The structured diagnostic approach and immediate management for a patient presenting with chest pain is discussed.

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Dr Adrian Spiteri MD FRCS Ed (A&E) FCEM (Corresponding author)

Consultant Emergency Medicine
St George’s Healthcare NHS Trust
Blackshaw Road
SW17 0QT

Dr Ruth Brown FRCS FCEM

Consultant Emergency Medicine
Imperial College Healthcare NHS Trust
St Mary’s Hospital
Praed street
W2 1NY


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