An acute dissection requires prompt diagnosis. A number of factors may contribute to a delay in diagnosing the condition. Too often the diagnosis is only made at autopsy.
Patient selection: acute aortic dissection
Reasons for delay in diagnosis include:
(1) young age with nonspecific symptoms and no history of a genetic disorder of connective tissue
(2) painless dissection
(3) lack of adequate imaging resources or delay in ordering
(4) comatose state
(5) dominance of symptoms related to malperfusion region (cerebral, coronary, visceral), such as (6) chest pain
(7) inexperience of clinician
(8) delay in patient presentation or being seen by a clinician
(9) low socioeconomic status
(10) history of condition in symptomatic region, such as back pain
In addition to delay in diagnosis, there may be a delay between diagnosis and surgery, especially in smaller hospitals.
