Aortic Dissection Detection (ADD) Risk Score

Parameters:

(1) predisposing condtions

(2) pain features

(3) physical findings

Predisposing conditions:

(1) Marfan syndrome or connective tissue disorder

(2) family history of aortic disease

(3) known aortic valve disease

(4) recent arotic manipulation

(5) known thoracic aortic aneurysm

Pain features related to chest/back/abdominal pain:

(1) abrupt onset

(2) severe intensity (VAS > 6 out of 10, need for opiates, 2 or more analgesics)

(3) ripping and/or tearing

Physical findings:

(1) pulse deficit

(2) systolic blood pressure difference (> 20 mm Hg)

(3) focal neurologic deficit in conjunction with pain

(4) new murmur of aortic insufficiency in conjunction with pain

(5) hypotension or shock

number of groups with 1 or more findings =

= SUM(number of groups with 1 or more findings)

Interpretation:

• minimum score: 0 (ADD 0)

• maximum score: 3 (ADD score > 1)

Performance:

• A score of 0 does not exclude aortic dissection.

• A score of 3 is more often seen with an alternative diagnosis.