title: [Diagnostic pathways and pitfalls in acute thoracic aortic dissection: practical recommendations and an awareness campaign].
abstract: Despite significant improvements in the surgical therapy of acute aortic dissection (AAD), mortality rates in the initial phase remain unacceptably high. Early diagnosis and therapy are essential to improving prognosis in these patients. A prerequisite of prompt and correct diagnosis is"thinking of it". Delayed or incorrect diagnosis can often have catastrophic results.The reported acute chest and back pain of a tearing, stabbing nature combined with the physiognomy of Marfan syndrome often arouse the clinical suspicion of AAD, prompting immediate imaging of the thoracic aorta and therapy. For less clear cases, additional hints drawn from the patient history and special findings from the medical examination are presented schematically in a diagnostic pathway. As an innovative form of diagnosis, preventive echocardiographic screening in high risk groups is discussed.To heighten awareness of AAD and the importance of its correct diagnosis, the poster campaign "Thinking of it can save lives" has been initiated. The poster depicts AAD schematically, indicates Marfan syndrome as a risk factor for AAD in young people and illustrates a CT scan as the most frequently performed imaging technique with high sensitivity and specificity.
authors.affiliation: Klinik für Herz- und thorakale Gefässchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
authors.forename: H-H
authors.initials: HH
authors.lastname: Sievers
authors.forename: C
authors.initials: C
authors.lastname: Schmidtke
mesh_terms: D000208:Acute Disease; D000465:Algorithms; D000784:Aortic Dissection / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D001794:Blood Pressure; D001835:Body Weight; D003937:Diagnosis, Differential; D004452:Echocardiography; D006801:Humans; D008382:Marfan Syndrome / Q000175:diagnosis / Q000601:surgery; D008403:Mass Screening; D012307:Risk Factors; D013577:Syndrome; D014891:Weight Lifting