What is the role of analgesics in the treatment of acute aortic dissection (AAD)?

Updated: Nov 09, 2018
  • Author: John M Wiesenfarth, MD, FACEP, FAAEM; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Pain control is essential to quality patient care. It ensures patient comfort, promotes pulmonary toilet, and prevents exacerbations of tachycardia and hypertension.

Checking for dissection prior to the administration of thrombolytics in the patient presenting with chest pain and ECG changes

Multiple case reports describe patients who received thrombolytics and were found later to have a dissection. The diagnosis of aortic dissection can be subtle.

The diagnosis depends on clinical suspicion, with contributory findings on history, physical examination, and imaging studies.

Obtaining a chest radiograph prior to administering thrombolytics is considered prudent.

Checking blood pressures in both arms and listening for carotid bruits also can help to diagnose aortic dissection prior to administering thrombolytics. The entire clinical picture must be taken into account.

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