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Accurate, early diagnosis of acute aortic dissection (AAD) is essential. To assess presenting features, investigators reviewed the cases of 464 patients enrolled in the International Registry of Acute Aortic Dissection.
Patients' mean age was 63 years, two thirds were male, and 62% had type A dissection (ascending aorta). More than 70% had a history of hypertension. Pain was the most common symptom (96%) of AAD, and was characterized as abrupt in onset (85%), severe (91%), and either sharp (60%) or tearing/ripping (51%). Chest pain occurred in 73%; anterior chest pain was more common in type A than type B (distal- to left-subclavian) disease (71% vs. 44%; P<0.001). Syncope also was significantly more common in type A, whereas back pain and a…