Persistent Chest Pain

Abstract

Acute aortic syndrome (AAS) comprises of a heterogeneous spectrum of conditions including penetrating aortic ulcer, intramural hematoma, and aortic dissection but can be expanded to include traumatic transection and ruptured atherosclerotic aneurysm. Computed tomography, magnetic resonance and transoesophageal echocardiography have all been shown to have high diagnostic accuracy in diagnosing AAS but in clinical practice, CT is the most commonly used modality. If the initial imaging is negative in the presence of high clinical index of suspicion for AAS, a second modality should be considered to prevent further delay.