When should I refer a patient with suspected aortic dissection to secondary care, and what information should I provide with the referral?

You should refer a patient with suspected aortic dissection to secondary care as an emergency ². Immediate hospital admission is recommended due to the high risk of death or serious morbidity associated with suspected aortic dissection ². This urgent referral is necessary if there is any suspicion of a serious cause for the patient's chest pain or any concern regarding their general well-being ². Aortic dissection should be considered as a life-threatening cause of chest pain, particularly if an acute coronary syndrome (ACS) is less likely based on clinical assessment and a resting 12-lead ECG ¹.

When referring a patient with suspected aortic dissection, you should include the following information:

• Clinical assessment findings: Detail the nature of the chest pain and any other associated symptoms ¹.
• Vital signs: Provide measurements for pulse, blood pressure, heart rhythm, and oxygen saturation ².
• Resting 12-lead ECG results: Take a resting 12-lead ECG as soon as possible and send the recording with the patient to the hospital ¹,². Ensure that recording and sending the ECG does not delay transfer to the hospital ¹,².
• Patient history: Include relevant risk factors and a careful history establishing the rate of onset and time to peak intensity of symptoms ⁴,⁵.
• Immediate management provided: Document any pre-hospital interventions, such as aspirin if given for suspected ACS ².