Prospective Feasibility Study of Point-of-care Ultrasound in Suspected Aortic Dissection

H0: patient selection and inclusion:

• Presentation of the study
• Delivery of the information note / no objection to the patient if he/she is in a state to consent
• Emergency procedure:

In accordance with article L-1122-1-3 of the public health code, patients may be included in the study at the initiative of the physician without seeking prior consent. This procedure will be associated with a prior call to the relatives to obtain an oral consent in principle (traced in the patient's medical file), while waiting for the delivery of the information note / no objection to the relatives and then to the patient as soon as his condition allows it.

H1: inclusion interview then :

Medical interrogation (retrospective collection if already done / but additional requests if missing data).

Clinical examination (complementary if missing data).

Ultrasound with 3 ultrasound sections to be performed: parasternal long axis, supra-sternal and abdominal, looking for the following signs:

Direct signs: presence of an intimal flap, intramural aortic hematoma > 5mm, penetrating aortic ulcer.

Indirect signs: pericardial effusion, aortic dilatation ≥ 4 cm, tamponade (1).

H4: retrospective collection of the results of complementary examinations if any, biological and radiological, and collection of the final diagnosis retained.

Inclusion criteria

• Men and women aged 18-95 years included
• Non-opposition of the subject to participate in the study
• All patients admitted to the emergency department of the Besançon University Hospital With chest, abdominal, back, lumbar pain, or acute headache
• AORTA score ≥ 1
• Clinical suspicion of AD by the emergency physician

Exclusion criteria

• Legal incapacity or limited legal capacity
• Subject unlikely to cooperate with the study and/or poor cooperation anticipated by the investigator
• Subject without health insurance
• Pregnant woman
• ECG showing acute coronary syndrome and/or ventricular rhythm disturbances
• Traumatic context, or traumatic cause of pain
• Chronic / subacute dissection (patient with incidental discovery of aortic dissection (city assessment) and then referred to the emergency room).
• Patient refusal to participate in the study