Identifying Acute Aortic Dissection Patients

It has been estimated that 5,000 to 10,000 aortic dissections occur in patients each year in the United States, and nearly one-third of these individuals will die before hospital discharge. Despite recent advances in diagnostic tools and surgery, the tearing of the aorta can be challenging for even the most experienced cardiovascular specialists to diagnose. In 2010, the American Heart Association and American College of Cardiology released clinical guidelines—developed in collaboration with 10 professional societies—for the diagnosis and management of thoracic aortic disease, emphasizing high-risk clinical features that indicate the presence of acute aortic dissection (AAD). Validation of these risk markers had yet to occur until the results of a study by the University of Michigan Cardiovascular Center (UMCC) published in 2011 in Circulation, which suggested patients with certain characteristics were likely to be suffering from an aortic dissection. “Over the past 20 years, much progress has been made in various facets of thoracic aortic disease,” says Kim A. Eagle, MD, co-author of both the guidelines for thoracic aortic disease and the aforementioned UMCC study. “This includes a better understanding of the natural history of thoracic aortic disease and the potential genetic factors that may underlie some of the aortic problems of the thorax. There has also been an evolution of modern imaging techniques for more reliable and speedy diagnoses and follow-up. Furthermore, new strategies for both medical and interventional therapy have emerged.” (see also, Strategies for Managing Thoracic Aortic Disease With Surgery). When compared with coronary heart disease, hypertension, or heart failure, thoracic aortic diseases are rarer, and therefore, probably encountered by practitioners less frequently. “As a result,”...