Acute aortic syndrome includes: aortic dissection, intramural hematoma, penetrating aortic ulcer, rupture aneurysm
Patient selection: acute onset of pain suspicious for aortic disease
Exclusions: history of dissection, trauma, prior aortic surgery
The diagnosis of acute aortic syndrome is excluded if pain is resolved by the time the patient is evaluated in the ED.
The patient is considered high risk for an acute aortic syndrome if one or both of the following are present:
(1) acute chest pain
(2) abnormal chest X-ray (widened mediastinum, abnormal aortic contour)
The authors performed a multivariate regression analysis on the data.
Parameters:
(1) acute onset of chest pain
(2) abnormal chest radiograph (widened mediastinum, abnormal aortic contour)
(3) history of hyperlipidemia
|
Parameter
|
Finding
|
Points
|
|
abnormal chest X-ray
|
no
|
0
|
|
|
yes
|
4.20
|
|
acute chest pain
|
no
|
0
|
|
|
yes
|
2.87
|
|
hyperlipidemia
|
no
|
0
|
|
|
yes
|
-2.86
|
X =
= SUM(points for all 3 parameters) - 4.07
probability of acute aortic syndrome =
= 1 / (1 + EXP((-1) * X))
