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Delayed Diagnosis of Aortic Dissection: A Scoping Review.
Yaru Xiao1, Sufang Huang1, Danli Zheng1
1Emergency Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030 Wuhan, Hubei, China.
Reviews in Cardiovascular Medicine
|July 9, 2025
Summary
Delayed diagnosis of aortic dissection (AD) is common and linked to patient factors like female sex and atypical symptoms such as painlessness or syncope. Improving clinician awareness of AD presentations is crucial for timely diagnosis and better patient outcomes.
Area of Science:
- Cardiology
- Vascular Surgery
- Diagnostic Imaging
Background:
- Aortic dissection (AD) carries a high early mortality rate.
- Timely diagnosis of AD is critical for effective management but remains challenging.
- Limited data exist on factors contributing to delayed AD diagnosis.
Purpose of the Study:
- To conduct a scoping review assessing the time to diagnosis for AD.
- To explore risk factors associated with delayed diagnosis of AD.
Main Methods:
- Scoping review conducted following PRISMA guidelines.
- Searches of multiple databases (PubMed, Web of Science, Cochrane, Bing, Wanfang, CNKI) for relevant studies.
- Inclusion of 27 studies evaluating diagnostic time and delayed diagnoses of AD.
Main Results:
- Diagnostic times varied significantly, from minutes to hours.
- Delayed diagnosis was associated with female sex, older age, specific geographic locations, and certain comorbidities.
- Atypical presentations like painlessness, syncope, and dyspnea were more common in delayed diagnoses, while typical symptoms like abrupt chest/back pain facilitated quicker diagnosis.
Conclusions:
- Recognizing typical and atypical AD presentations is key for rapid diagnosis.
- Educational initiatives to enhance clinician awareness of AD are needed, especially in non-tertiary care settings.
- Improving AD recognition can lead to faster diagnosis and potentially better patient outcomes.
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