Sudden tearing pain moving from chest to back or lower back warrants 120; tell the dispatcher that the pain is moving
Describe abrupt tearing pain that moves downward when calling China's 120. In the cited registry, medically managed type A aortic dissection had 58% mortality. The source stresses that treatment differs from a heart attack: recognizing dissection prompts contrast CT rather than anticoagulation or thrombolysis. Mention markedly different arm blood pressures or a missing pulse on one side.
What it takes
No cost to take the immediate action.
What you may gain
The International Registry of Acute Aortic Dissection included 464 cases from 12 centers. Abrupt severe sharp pain was the most common initial symptom. Overall in-hospital mortality was 27.4%; for type A dissection treated medically without surgery it was 58%.
Context & considerations
The source contrasts dissection treatment with anticoagulant or thrombolytic treatment used for heart attacks, because preventing clotting can worsen bleeding from a dissection. Clearly describing tearing, migrating pain helps clinicians consider contrast CT. Unequal arm pressures and a missing pulse are clues. Poorly controlled blood pressure, Marfan syndrome and a family history of aortic aneurysm/dissection increase risk. Do not drive yourself or wait until tomorrow.
Research & references
Hagan PG, Nienaber CA, Isselbacher EM, et al. (2000). The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA, 283(7), 897-903. https://doi.org/10.1001/jama.283.7.897