Can’t Miss Diagnoses – Aortic Dissection
- Recognizing early signs
- Maintaining suspicion of AD
- Ordering imaging appropriately
The Can’t Miss Diagnosis series focuses on diseases that are relatively rare, difficult to diagnose, and catastrophic when diagnosis and treatment are delayed. The key to good outcomes for these diseases is to be prepared in advance to recognize and treat them, and to address individual cases with a high index of suspicion for disorders that are infrequently seen.
Aortic dissection is rare, but complications develop rapidly, and the outcome is often fatal. In an aortic dissection, a break in the inner wall of the aorta allows blood to surge between the inner and outer layers of the aortic wall. The blood under pulse pressure dissects the middle layer of the aorta, creating a propagating split in the aortic wall.
Did you know…
- Mortality is 40% on presentation of aortic dissection, plus 1¬–2% with each passing hour
- 39% of aortic dissection cases are only recognized >24 hours after admission—very late!—and 20–40% are diagnosed at autopsy
- Outcomes improve sharply with prompt surgery, falling to 15–20% mortality at one month and 45% at ten years
- Aortic dissection is survivable, but it requires rapid expert diagnosis and treatment.
Course at a Glance
Target Audience: Clinicians
Time to Complete: 30 Minutes
Contributor: Swedish Medical Center
Swedish Medical Center, Providence Health & Services
Course development guided by the expertise of Dr. Per Danielsson, who is a board-certified internist at Swedish Medical Center in Seattle, WA. In his Can’t Miss Diagnoses courses, Dr. Danielsson shares his deep expertise in identifying endangered patients, treating underlying causes, and responding to challenging cases by navigating through a variety of therapy options. Good outcomes in these cases require swift, well-informed diagnosis and treatment.