Diagnostic Testing in Acute Aortic Dissection

Abstract

Acute aortic dissection (AAD) is the most common catastrophe to involve the aorta, resulting in high morbidity and mortality. Delayed diagnosis can adversely affect patient outcome, therefore a high clinical index of suspicion is the first step. Absence of the classical signs such as pulse defecit and chest radiograph changes should not falsely reassure clinicians. Availability of a biomarker to expedite and improve diagnosis of AAD would greatly benefit emergency department clinicians. Some promising novel biomarkers include calponin and elastin, but their use in everyday practice is still some time away. Bedside imaging including transthoracic and transesophageal echo is being increasingly used in the unstable patient suspected of AAD, while computed tomography (CT) appears to be the most accurate rapid imaging modality for its diagnosis. Expeditious diagnosis is crucial to improve patient survival allowing for better outomes.