Ripping the Myth: Patients’ Symptomatic Descriptions of Acute Thoracic Aortic Dissection

CONTEXT: The objective of this retrospective project was to assess the frequency with which patients presenting to an emergency department had used the descriptive terms “ripping” and “tearing” to describe their symptoms from later-confirmed acute thoracic aortic dissection. METHODS: The authors conducted a retrospective chart review from 58 patients who had presented to two suburban and urban emergency departments with suspected acute thoracic dissection between 1997 and 2015. They reviewed charts for patients’ pain descriptors in ambulance personnel records and initial notes and dictations from ED triage nurses, staff nurses, and physicians. These pieces of documentation would have been made before the diagnosis of acute thoracic aortic dissection could been confirmed. RESULTS: The authors identified a sample subset of 29 (50% of total charts pulled) patients later confirmed to have had an acute thoracic aorta dissection. They found that no sample patients used either the descriptors “ripping” or “tearing” when communicating their presenting symptoms. In this paper, the authors will provide several alternative terms patients have been shown to offer for this life-threatening condition. CONCLUSIONS: Although the terms “ripping” and “tearing” have historically been associated with acute thoracic aortic dissections, these project results indicate that clinicians may consider other descriptive symptomatic terms from patients when evaluating patients’ symptoms for this potential life-threatening condition.