Table 3.19-2. Factors increasing the probability of acute aortic syndrome


Marfan syndrome (or other connective tissue disease)

Family history of aortic disease

Known aortic valve disease

Known thoracic aortic aneurysm

Previous aortic manipulation (including cardiac surgery)

Pain features

Chest, back, or abdominal pain characterized by any of:

– Abrupt onset

– Severe intensity

– Ripping or tearing

Examination features

Evidence of perfusion deficit:

– Pulse deficit

– Systolic blood pressure difference in upper limbs

– Focal neurologic deficit (in conjunction with pain)

Aortic diastolic murmur (new and with pain)

Hypotension or shock

The presence of features from one of the groups amounts to 1 point; from 2 groups, 2 points; and from 3 groups, 3 points. The higher the score on a scale from 0 to 3, the higher the risk of acute aortic syndrome before additional diagnostic tests are performed.

Based on Circulation. 2010 Apr 6;121(13):e266-369.