https://doi.org/10.4081/ecj.2023.11433

Comments on “Why do emergency department clinicians miss acute aortic syndrome? A case series and descriptive analysis”

Vol. 19 No. 2 (2023): In Memory of Barbara Capovani
Submitted: 26 April 2023
Accepted: 8 May 2023
Published: 23 June 2023
Aortic dissection, aorta, point-of-care ultrasound, ultrasound
Abstract Views: 239
PDF: 202
Supplementary Materials: 129
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Authors

Andrea Vercelli
a.vercelli@ausl.pc.it
Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
Eleonora Berardi
Emergency Department, University Hospital of Parma, Parma, Italy.
Erika Poggiali
Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.

Dear Editor,

In the recently published article by McLatchie et al., the authors state that emergency clinicians may miss acute aortic syndrome (AAS) by not considering it as a possibility, being falsely reassured by atypical or resolved symptoms, or mistaking it for other more common conditions.1 The authors emphasise the importance of always considering AAS in the differential diagnosis of chest, back or abdominal pains, collapse, perfusion deficits or neurological compromise and suggest a risk stratification scoring system such as ADD-RS in combination with D-dimer to standardise the approach and help physicians discern which patients to scan. [...]

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McLatchie R, Wilson S, Reed M, et al. Why do emergency department clinicians miss acute aortic syndrome? A case series and descriptive analysis. Emerg Care J 2023;19:11153. DOI: https://doi.org/10.4081/ecj.2023.11153
Hiratzka LF, Bakris GL, Beckman JA, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/ SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease: a report of the American College of cardiology Foundation/ American heart association Task force on practice guidelines, American association for thoracic surgery, American College of radiology, American stroke association, society of cardiovascular Anesthesiologists, Society for cardiovascular angiography and interventions, society of interventional radiology, society of thoracic surgeons, and Society for vascular medicine. Circulation 2010;121:e266–369.
Nazerian P, Mueller C, Vanni S, et al. Integration of transthoracic focused cardiac ultrasound in the diagnostic algorithm for suspected acute aortic syndromes. Eur Heart J 2019;40:1952-60. DOI: https://doi.org/10.1093/eurheartj/ehz207
Fojtik JP, Costantino TG, Dean AJ. The diagnosis of aortic dissection by emergency medicine ultrasound. J Emerg Med 2007;32:191-6. DOI: https://doi.org/10.1016/j.jemermed.2006.07.020
Gibbons R, Smith D, Mulflur M, et al. 364 Point-of-care ultrasound for the detection of aortic dissections in the emergency department. Ann Emerg Med 2017;70:S143. DOI: https://doi.org/10.1016/j.annemergmed.2017.07.334
Perkins AM, Liteplo A, Noble VE. Ultrasound diagnosis of type a aortic dissection. J Emerg Med 2010;38:490-3. DOI: https://doi.org/10.1016/j.jemermed.2008.05.013
Bernett J, Strony R. Diagnosing acute aortic dissection with aneurysmal degeneration with point of care ultrasound. Am J Emerg Med 2017;35:1384.e3-e4. DOI: https://doi.org/10.1016/j.ajem.2017.05.052
Olsson C, Thelin S, Ståhle E, et al. Thoracic aortic aneurysm and dissection: increasing prevalence and improved outcomes reported in a nationwide population-based study of more than 14,000 cases from 1987 to 2002. Circulation 2006;114:2611-8. DOI: https://doi.org/10.1161/CIRCULATIONAHA.106.630400

How to Cite

Vercelli, A., Berardi, E., & Poggiali, E. (2023). Comments on “Why do emergency department clinicians miss acute aortic syndrome? A case series and descriptive analysis”. Emergency Care Journal, 19(2). https://doi.org/10.4081/ecj.2023.11433
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