{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:37:10Z","timestamp":1790012230958,"version":"4.0.1"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2019,3,25]],"date-time":"2019-03-25T00:00:00Z","timestamp":1553472000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJEM"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec id=\"S1481803519000010_sec_a2\" sec-type=\"intro\"><jats:title>Introduction<\/jats:title><jats:p>Acute aortic dissection (AAD) is a time sensitive, difficult to diagnose, aortic emergency. We sought to explore the quality of history taking in AAD and assess its impact on misdiagnosis.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803519000010_sec_a3\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>We studied a retrospective cohort of patients &gt;18 years old who presented to two tertiary care emergency departments from January 1st 2004 \u2013 December 31<jats:sup>st<\/jats:sup> 2012 and were diagnosed with an acute aortic dissection (AAD) on CT, MRI or TEE. Trained reviewers\u2019 extracted data using a standardized data collection form. The definitions of 5 pain characteristics \u2013 character, onset, duration, quality, and radiation were defined a priori.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803519000010_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Data were collected for 194 cases of acute aortic dissection with a mean age of 65(SD 14.1) and 66.7% male, 34(17.6%) missed on initial presentation. Only 20(14.8%) patients were asked all 5 questions. The most common initial incorrect diagnosis were acute coronary syndrome (16, 47%), pulmonary embolism (5, 14.7%) and stroke (4, 11.7%). If &lt;2 questions were asked 1 in 5 cases were missed, 4 times greater than if &gt;2 were asked (P &lt; 0.01).<\/jats:p><\/jats:sec><jats:sec id=\"S1481803519000010_sec_a5\" sec-type=\"conclusion\"><jats:title>Conclusion<\/jats:title><jats:p>Clinicians should ask and document the character, onset, duration, radiation and severity of pain in any patient presenting with chest, abdominal or flank pain. A focused history still remains the keystone to reducing misdiagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1017\/cem.2019.1","type":"journal-article","created":{"date-parts":[[2019,3,25]],"date-time":"2019-03-25T09:17:40Z","timestamp":1553505460000},"page":"618-621","source":"Crossref","is-referenced-by-count":10,"title":["A simple intervention to reduce your chance of missing an acute aortic dissection"],"prefix":"10.1007","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8263-0556","authenticated-orcid":false,"given":"Robert","family":"Ohle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Mc Isaac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2134-9597","authenticated-orcid":false,"given":"Jeffrey J.","family":"Perry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,3,25]]},"reference":[{"key":"S1481803519000010_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2013.06.005"},{"key":"S1481803519000010_ref3","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12828"},{"key":"S1481803519000010_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2011.07.008"},{"key":"S1481803519000010_ref5","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13356"},{"key":"S1481803519000010_ref2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.006320"},{"key":"S1481803519000010_ref9","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13360"},{"key":"S1481803519000010_ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s10140-018-1587-x"},{"key":"S1481803519000010_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.10.055"},{"key":"S1481803519000010_ref1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.114.3.793"},{"key":"S1481803519000010_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2004.07.006"}],"container-title":["CJEM"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1481803519000010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T23:40:37Z","timestamp":1609458037000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1481803519000010\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,25]]},"references-count":10,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,9]]}},"alternative-id":["S1481803519000010"],"URL":"https:\/\/doi.org\/10.1017\/cem.2019.1","relation":{},"ISSN":["1481-8035","1481-8043"],"issn-type":[{"value":"1481-8035","type":"print"},{"value":"1481-8043","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,25]]}}}