Clinical Manifestations and Physical Exam-acute aortic syndromes

(JAMA 2000;283:897) Feature

• Proximal Distal

“Aortic” pain (abrupt, severe, tearing or ripping quality, maximal at onset [vs. crescendo for ACS])

94% (chest, back) 98% (back, chest, abd)

Syncope (often due to tamponade)

13% 4%

HF (usually due to acute AI)

9% 3%

CVA

6% 2%

HTN

36% 70%

HoTN or shock (tamponade, AI, MI, rupture)

25% 4%

Pulse deficit (if involves carotid, subclavian, fem)

19% 9%

AR murmur

44% 12%

*S/S correlate w/ affected branch vessels & distal organs; may ∆ as dissection progresses