Key result
Female sex, atypical symptoms, initial suspicion of coronary disease, and presentation at tertiary care hospitals are the most relevant factors associated with critical delays in the diagnosis and treatment of proximal aortic dissection.
Why the study?
Proximal aortic dissection carries an incremental risk of death of 1-2% per hour from symptom onset, and early diagnosis remains a challenge despite diagnostic advances.
Systematic Review
Delayed diagnosis of proximal aortic dissection is frequently associated with female sex, atypical symptoms, and initial misdiagnosis as coronary disease, highlighting the need for high clinical suspicion.
Clinicians should heighten suspicion for aortic dissection in females with atypical symptoms; supports targeted protocols to reduce diagnostic delays.
Background: Proximal aortic dissection is characterized by the formation of a false lumen in the medial layer of the aortic wall. This pathology has an incremental risk of death of 1-2% for each hour since the onset of symptoms. Despite notable advances in diagnostic tools, early diagnosis of this pathology remains a challenge. Material and methods: A systematic review of published studies on acute aortic dissection was performed with a focus on factors associated with a delay in diagnosis and early treatment. Results: The search yielded 16 articles where patient, diagnostic, and treatment availability factors were identified. Among the most relevant factors are the female sex, atypical symptoms, suspicion of coronary disease, and the initial presentation in tertiary care hospitals. Conclusion: The main findings of this systematic review were numerous variables that are associated with a delay in diagnosis and treatment, including patient factors, level of diagnostic suspicion, diagnostic methods used, and level of complexity of the receiving medical center
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Batistetti et al. (2023) conducted a systematic review in Proximal Aortic Dissection. Factors associated with diagnostic delay (e.g., female sex, atypical symptoms, suspicion of coronary disease) was evaluated on Factors associated with a delay in diagnosis and early treatment. Female sex, atypical symptoms, initial suspicion of coronary disease, and presentation at tertiary care hospitals are the most relevant factors associated with critical delays in the diagnosis and treatment of proximal aortic dissection.
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