title: Acute aortic dissection in the emergency department: diagnostic challenges and evidence-based management.
abstract: Acute aortic dissection in the emergency department (ED) remains one of the riskiest clinical and medicolegal challenges facing ED physicians. The variability in clinical presentations and mimics, the unreliability of clinical assessments and initial screening tools, and the need for advanced imaging all present obstacles in making an accurate and timely diagnosis for this entity. This article reviews available information and evidence regarding pathophysiology, risk factors, clinical variations in presentation, the usefulness of different diagnostic testing modalities, and management options in the ED when considering this diagnosis. Key recommendations from recent guidelines are reviewed in the context of ED practice.
authors.affiliation: Division of Emergency Medicine, McMaster University, Room 254, Second Floor, McMaster Building, 237 Barton Street East, Hamilton, Ontario, L8L 2X2, Canada. upadhyes@mcmaster.ca
authors.forename: Suneel
authors.initials: S
authors.lastname: Upadhye
authors.forename: Karen
authors.initials: K
authors.lastname: Schiff
mesh_terms: D000208:Acute Disease; D000784:Aortic Dissection / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D015415:Biomarkers / Q000032:analysis; D019468:Disease Management; D004562:Electrocardiography; D004630:Emergencies; D019317:Evidence-Based Medicine; D006801:Humans; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers