Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Simple new bedside screening effectively identifies patients with acute aortic dissection

Risk score can help diagnose aortic dissection, like the condition that caused sudden death of actor John Ritter, University of Michigan Cardiovascular Center study shows

The most lethal and sudden cardiovascular event can be the toughest for doctors to diagnose.

But a study by the University of Michigan Cardiovascular Center shows new guidelines are effective for determining who's most likely suffering from an aortic dissection, which is tearing in the lining of the body's largest blood vessel.

Aortic dissection lead to the sudden death of award-winning TV actor John Ritter in 2003, and brought the world's attention to a heart condition that few survive.

The U-M study shows that with the help of an aortic dissection detection risk score, generated by a simple, bedside screening tool, doctors can usually identify signs or symptoms of acute aortic dissection, which include abrupt, intense pain.

The study was published online ahead of print May 24 in the American Heart Association's journal Circulation.

"The results from this study suggest that the risk score, with the use of only information that is available at the bedside, can identify the vast majority of patients presenting with acute aortic dissection," says study senior author and cardiologist Kim A. Eagle, M.D., a director of the U-M Cardiovascular Center.

Nearly 10,000 Americans suffer aortic dissections each year, and nearly one in three dies before leaving the hospital despite recent advances in diagnostic tools and surgical treatment.

The U-M is the coordinating center for the largest-ever study of aortic dissection patients and the study results were compiled from the International Registry of Acute Aortic Dissection.

Of the 2,538 IRAD patients examined, 95 percent had one or more of the 12 proposed clinical risk markers and 86 percent had at least two of the risk markers.

Patients with acute aortic dissection frequently had an abrupt onset of pain, severe intensity of pain and pain described as ripping or tearing, according to the study.

U-M radiology and cardiology experts helped the American Heart Association, American College of Cardiology and other professional societies create the 2010 thoracic aortic disease guidelines.

The ADD risk score was created from these guidelines to provide doctors with a fast, simple and systematic method for screening large volumes of patients at the bedside.

"Because of its symptoms, aortic dissection is often mistaken for other cardiovascular conditions," says study co-author Adam M. Rogers, M.D., also of U-M.

Those who have lived through aortic dissection describe it as the most painful thing that ever happened to them. Blood, surging from the heart into the main artery, forces open a tiny rip in the aorta's lining that grows and threatens to burst like a dam in a flood.

While tears in the lining of the body's largest blood vessel are rare, occurring in 5,000 to 10,000 patients a year, they have long been known to be deadly. Without emergency attention and treatment — and even, often with it — the torn lining can continue to rip, block blood flow to key arteries in the body, cause the heart to fail, or make the aorta swell into an aneurysm or rupture entirely.

Aortic dissections are the leading cause of death among people with Marfan syndrome, a genetic disorder that weakens the aorta.

Also at risk are people with other heart valve and aorta problems, high blood pressure, or a family history of aortic dissections. Some people with aortic dissection can achieve a stable state with their condition, at least for a while, but most cases are acute and must be treated quickly.

Aortic dissection's symptoms often mimic those of other cardiovascular conditions — resulting in delayed diagnosis. Symptoms include instantaneous onset of severe chest or back pain, sharp drops in blood pressure, altered consciousness, and even limb paralysis.

Only when patients reach an emergency room and undergo tests and scans can the cause be spotted. The two best imaging techniques for finding a dissection are computed tomography, or CT, or trans-esophageal echocardiography.

After diagnosis, ER staff may decide to send the patient to an aortic center that has specialized staff and equipment to handle the condition - such as U-M and the other IRAD participating hospitals.

Additional Authors: Anna M. Booher, M.D.; David M. Williams, M.D.; Ella A. Kazerooni, M.D.; James B. Froehlich, M.D.; and Jeanna V. Cooper, M.D., of the University of Michigan Health System; Luke K. Herman, M.D., Mt. Sinai Hospital; Christoph A. Neinaber, M.D., University Hospital Rostock, Rostock, Germany; Patrick T. O'Gara, M.D., Brigham and Women's Hospital, Boston; Daniel G. Montgomery, B.S., Kevin M. Harris, M.D., Minneapolis Heart Institute; Stuart Hutchinson, M.D., University of Calgary, Albert, Canada; Arturo Evangelista, M.D., Hospital General Univri Vall D'Hebron, Barcelona, Spain, and Eric M. Isselbacher, M.D., Massachusetts General Hospital. more

Reference: "Sensitivity of the aortic dissection detection risk score, a novel guideline based tool for identification of acute aortic dissection at initial presentation: Results from the International Registry of Acute Aortic Dissection," Circulation, May 24, 2011.

Funding: IRAD is supported by grants from the University of Michigan Health System, Varbedian Fund for Aortic Research, Hewlett Foundation, Mardigan Foundation, and Gore Inc.


University of Michigan Cardiovascular Center
International Registry of Acute Aortic Dissection
U-M Multidisciplinary Aortic Program

Shantell M. Kirkendoll | EurekAlert!
Further information:

More articles from Studies and Analyses:

nachricht Diagnoses: When Are Several Opinions Better Than One?
19.07.2016 | Max-Planck-Institut für Bildungsforschung

nachricht High in calories and low in nutrients when adolescents share pictures of food online
07.04.2016 | University of Gothenburg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Etching Microstructures with Lasers

Ultrafast lasers have introduced new possibilities in engraving ultrafine structures, and scientists are now also investigating how to use them to etch microstructures into thin glass. There are possible applications in analytics (lab on a chip) and especially in electronics and the consumer sector, where great interest has been shown.

This new method was born of a surprising phenomenon: irradiating glass in a particular way with an ultrafast laser has the effect of making the glass up to a...

Im Focus: Light-driven atomic rotations excite magnetic waves

Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion

Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Greater Range and Longer Lifetime

26.10.2016 | Power and Electrical Engineering

VDI presents International Bionic Award of the Schauenburg Foundation

26.10.2016 | Awards Funding

3-D-printed magnets

26.10.2016 | Power and Electrical Engineering

More VideoLinks >>>