Aortic dissection is a rare but life-threatening condition that needs to be recognised in the emergency department. It can be fatal if missed. In the UK incidence is 2-3/100,000 per year. It is the commonest cardiac
surgical emergency and affects working age people. Without intervention
most will die within one month.
The European Society of Emergency Medicine congress featured presentations from ‘Think Aorta’, a patient-led collaboration between patient association Aortic Dissection Awareness (UK & Ireland), the Royal College of Emergency Medicine, the Irish Association for Emergency Medicine, the Society for Cardiothoracic Surgery and Heart Research UK.
Cardiac surgeon, Debbie Harrington, Consultant Cardiac and Aortic Surgeon at Liverpool Heart and Chest Hospital outlined the outcomes for aortic dissection: if unoperated, mortality is 1% per hour in the first 48 hours, if operated, between 12-22% mortality and long term survival 70% if operated on. (data from UK of Society for Cardiothoracic Surgery in Great Britain & Ireland).
Central to the ‘Think Aorta’ campaign success is to bring change to the healthcare system:
- Think aorta
- Routine CT scanning
- Robust policy training and guidelines
- Organisation of cardiac emergency services
Patients may present with severe chest and/or back and/or abdominal pain. Not every patient with severe pain has acute coronary syndrome. They may feel bursting 'something popped', or a ripping or tearing as sudden onset. They may have elevated and unequal blood pressure.
Catherine Fowler, Vice-Chair of Aortic Dissection Awareness (UK & Ireland), explained that the “Think Aorta” campaign aims to spread awareness and best practice in emergency departments about this diagnosis. Fowler’s father, Tim Fleming, died of an aortic dissection in 2015 after being sent home from the emergency department with an incorrect diagnosis of gastritis.
The campaign’s data shows that that a diagnosis of aortic dissection is considered in less than half of patients who arrive at the emergency department with the condition. One-third of patients with aortic dissection are actively treated in the emergency department for a different, incorrect diagnosis. The only way to definitively diagnose aortic dissection is by a CT scan.
Aortic Dissection Awareness Day 19th September
Wednesday 19th September marks Aortic Dissection Awareness day. The Think Aorta campaign has resources available on its website, including a poster. The Royal college of emergency Medicine with the campaign Learning has a podcast.
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aortic dissection, European Society of Emergency Medicine, #EuSEM18, Think Aorta
The European Society of Emergency Medicine congress featured presentations from ‘Think Aorta’, a patient-led collaboration between patient association Aortic Dissection Awareness (UK & Ireland), the Royal College of Emergency Medicine, the Irish Associati
