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[384], 'back': [389], 'pain)': [390], 'findings': [393, 641], 'suggestive': [394], '(hypotension,': [398], 'deficits).': [400], 'most': [402], 'rapid': [403, 869, 1027], 'made': [406], 'computed': [408], 'tomography': [409], 'echocardiography': [411], 'as': [412, 436, 921, 1040, 1197, 1422], 'imaging': [414, 420, 1282, 1318, 1374], 'modality': [415], 'rather': [416], 'than': [417, 487, 506, 623, 710, 732, 750], 'magnetic': [418], 'resonance': [419], 'angiography.': [422], 'Unexpectedly,': [423], 'known': [425, 440, 796, 1049, 1426], 'predispose': [427], 'be': [430, 1007, 1138, 1258, 1284, 2363, 2413], 'dissections,': [434, 808, 919, 1125, 1420], 'such': [435, 920, 1039, 1177, 1421], 'Marfan': [437, 1369], 'syndrome,': [438, 1047], 'new': [446], 'insufficiency': [448], 'murmur': [449], 'examination,': [451, 943], 'did': [452], 'significantly': [454, 471, 730], 'decrease': [455], 'diagnosis.': [459], 'Another': [460], 'surprising': [461, 1175], 'finding': [462], 'women.': [474, 670], 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[577], 'deaths': [579, 668], 'due': [580, 681, 698], "examiner's": [588, 621, 705, 725], 'office,': [589], 'one': [590], 'third': [591], 'cases': [594, 720, 735, 747], 'sought': [595], 'care': [597], 'abdominal': [602, 691, 925, 1998], 'dyspnea': [605], 'within': [606, 1225], 'week': [608], 'preceding': [609], 'death.8': [610], 'Furthermore,': [611], 'more': [612, 666], 'office': [622, 706, 726], 'hospitals': [629, 838], 'according': [630], 'others': [636], '(42%': [637], 'versus': [638], '33%).': [639], 'suggest': [642, 992], 'only': [651], 'women,': [654], 'but': [655, 676, 1409], 'lack': [658], 'may': [662], 'out-of-hospital': [667], 'lower': [672], 'frequency': [673], 'disease': [675], 'rupture': [684], 'aneurysms.9The': [693], 'younger': [709, 731, 749], 'hospitals.': [715], 'average': [717], 'age': [718, 757], '(52': [727], 'years)': [728], 'registry': [739], '(60': [740], 'years,': [741], 'P<0.01).': [742], 'fact,': [744], '>40%': [745], '50': [751], 'years.': [752], 'difference': [755], 'represent': [759], 'fewer': [760], 'autopsies': [761], 'being': [762], 'performed': [763, 969, 1217], 'individuals': [766, 779, 1341, 1414, 1523, 1540], 'death,': [769], 'important': [772], 'remember': [774], 'occur': [778], 'ages,': [782], 'including': [783], 'children': [784, 1087], 'young': [786, 789, 824, 1089], 'adults.': [787], 'Many': [788], 'will': [793, 1112, 1517], 'risk': [797, 939, 953, 979, 1035, 1102, 1118, 1267, 1274, 1343, 1463, 1491, 1562, 2078], 'factor': [798, 980], 'for': [799, 897, 911, 998, 1037, 1094, 1147, 1203, 1260, 1268, 1304, 1306, 1344, 1413, 1466, 1564, 1655, 1686, 1701, 1716, 1796, 2084, 2495], '(features': [801], 'genetic': [804, 2022], 'syndrome': [805, 1370], 'predisposing': [806, 996, 1417], 'bicuspid': [809, 1052, 1433], 'valve,': [811, 1435], 'family': [813, 1056, 1448], 'and/or': [818], 'aneurysms).': [819], 'Tragically,': [820], 'their': [823], 'properly': [832], 'diagnosed': [833], 'despite': [834], 'repeated': [835], 'visits': [836], 'there': [840], 'low': [843, 1266, 1311], 'index': [845], 'suspicion.10The': [847], 'another': [854], 'step': [855], 'toward': [856], 'improving': [857], 'dissections.': [864, 1205, 1360, 1455], 'Initial': [865], 'steps': [866], 'improve': [868, 1559], 'previously': [876], 'taken': [877], 'American': [880, 885, 1583, 1672, 1684, 1689, 1693, 2517], 'College': [881, 1673, 1690], 'Cardiology': [883, 1675], 'Heart': [886, 1584, 1677, 1977, 2518], 'Association': [887, 1678, 1685], 'Task': [888, 1679], 'Force': [889, 1680], 'Practice': [891, 1682], 'Guidelines': [892, 1654], 'inaugural': [895], 'guidelines': [896], 'management': [899, 909, 1098, 1353, 1362], 'disease,': [903, 1061, 1445], 'which': [904], 'included': [905], 'evaluation': [907], 'algorithm': [910, 956, 1022, 1099], 'symptoms': [915, 1231, 1278], 'possibly': [916], 'attributed': [917], 'chest,': [922], 'back,': [923], 'syncope.1': [928], 'On': [929], 'basis': [931, 1272], 'targeted': [934], 'assess': [937], 'classified': [947], 'into': [948, 1009, 1496], 'low,': [949], 'intermediate,': [950], 'categories.': [954], 'tested': [958], 'centers': [967], 'well,': [970], '95.7%': [972], 'identifiable': [976], 'symptom': [983], 'sign': [985], 'dissection.11': [989], 'assessment': [994, 1028, 1262, 1563], 'dissection,': [999, 1038, 1530, 2316], 'along': [1000], 'signs': [1003, 1106], 'should': [1006], 'hardwired': [1008], 'department': [1011], 'triage': [1012, 1064], 'protocols': [1013, 1406], 'electronic': [1015], 'record': [1017], 'systems.': [1018], 'Incorporation': [1019], 'would': [1023, 1137, 1283, 1290, 1313], 'those': [1041, 1576], 'Marfan,': [1043], 'Loeys-Dietz,': [1044], 'Turner': [1046], 'valve': [1054], 'subsequent': [1063], 'diagnostic': [1066, 1307], 'imaging.': [1067], 'If': [1068], 'uniformly': [1069], 'assessed': [1070, 1093], 'patients,': [1073], 'potentially': [1076, 1199], 'reduce': [1077], 'ensure': [1085], 'adults': [1090], 'accurately': [1092], 'dissections.The': [1095], 'newly': [1096, 2028], 'proposed': [1097], 'focuses': [1100], 'factors,': [1103, 1119, 1275, 1464], 'address': [1114], 'vague': [1121], 'complaints': [1122], 'findings.': [1130], 'situations,': [1133], 'greatly': [1139], 'improved': [1140], 'sensitive': [1143], 'specific': [1145], 'biomarker': [1146, 1181, 1202], 'Because': [1150], 'involves': [1154], 'destruction': [1155], 'thick': [1158], 'muscular': [1159], 'layer': [1160], 'wall': [1164], 'composed': [1165], 'smooth': [1167, 2205], 'muscle': [1168, 2206], 'cells': [1169], 'elastin': [1171], 'fibers,': [1172], 'clinically': [1179, 1200], 'useful': [1180, 1201], 'has': [1182], 'been': [1183, 1494], 'elusive.': [1184], 'Levels': [1185], 'D-dimer,': [1187], 'breakdown': [1189], 'product': [1190], 'cross-linked': [1192], 'fibrin': [1193], 'molecules,': [1194], 'emerged': [1196], 'prospective': [1208], 'centers,': [1213], 'D-dimer': [1214, 1255, 1288], 'levels': [1215, 1256, 2304], 'indeed': [1216], 'well': [1218], 'diagnosing': [1220], 'if': [1223], 'assayed': [1224], 'first': [1227], '24': [1228], 'hours': [1229], 'threshold': [1235], 'level': [1236, 1289, 1312], '500': [1238], 'ng/mL': [1239], '(negative': [1240], 'likelihood': [1241], 'ratio': [1242], '0.07': [1244], 'negative': [1247], 'predictive': [1248], 'value': [1249], '95%).12': [1251], 'Given': [1252], 'findings,': [1254], 'used': [1259], 'further': [1261, 1281, 1548], 'signs,': [1276], 'pursuing': [1280], 'questionable.': [1285], 'increase': [1291, 1457], 'suspicion': [1293], 'pulmonary': [1298], 'emboli': [1299], 'thus': [1301], 'provide': [1302], 'support': [1303, 1314], 'triaging': [1305], 'imaging,': [1308], 'whereas': [1309], 'conclusion': [1316], 'necessary.The': [1321], 'ultimate': [1322], 'challenge': [1324], 'morbidity': [1329], 'through': [1337], 'identification': [1339, 2085], 'initiation': [1348], 'Such': [1361], 'now': [1364], 'routine': [1365], 'includes': [1372], 'periodic': [1373], 'aorta,': [1378], 'growth': [1386], 'once': [1396], 'cm.': [1404], 'Similar': [1405], 'always': [1411], 'followed': [1412], 'dilatation,': [1431], 'mutation': [1437], 'gene': [1440], 'familial': [1442], 'To': [1456], 'public': [1459], 'awareness': [1460], 'general,': [1470], 'Thoracic': [1472, 1663, 1687, 1712, 2357, 2496], 'Disease': [1474], 'Coalition,': [1475], 'organization': [1477], 'foundations': [1479], 'physicians': [1481], 'shared': [1484], 'mission,': [1485], 'recently': [1487], 'founded': [1488], '(http://www.tadcoalition.org).': [1489], 'condensed': [1495], 'Ritter': [1498], 'Rules': [1499], 'honor': [1501], 'comedian': [1504], 'actor': [1506], 'John': [1507], 'Ritter,': [1508], 'who': [1509, 1524], 'died': [1510], 'dissection.': [1513, 1901, 1949], 'But': [1514], 'rules': [1516], 'identify': [1519, 1538, 1553], 'majority': [1521], 'unanswered': [1533], 'question': [1534], 'how': [1536], 'before': [1541], 'occurs.': [1543], 'It': [1544], 'clear': [1546], 'needed': [1551], 'genes': [1555], 'biomarkers': [1557], 'general': [1566], 'population.DisclosuresNone.FootnotesThe': [1567], 'opinions': [1568], 'expressed': [1569], 'necessarily': [1575], 'editors': [1579], 'Association.Correspondence': [1585], 'PhD,': [1590], 'Division': [1591], 'Medical': [1593, 1602], 'Genetics,': [1594, 2445], 'School': [1603], '6431': [1606], 'Fannin,': [1607], 'MSB': [1608], '6.100,': [1609], 'TX': [1611], '77030.': [1612], 'E-mail': [1613], 'dianna.m.[email': [1614], 'protected]tmc.eduReferences1.': [1615], 'Hiratzka': [1616], 'LF,': [1617], 'Bakris': [1618], 'GL,': [1619], 'Beckman': [1620], 'JA,': [1621, 1647, 2118], 'Bersin': [1622], 'RM,': [1623], 'Carr': [1624], 'VF,': [1625], 'Casey': [1626], 'DE,': [1627, 1889], 'Eagle': [1628, 1751, 1809, 1894, 2070, 2139], 'KA,': [1629, 1810], 'Hermann': [1630, 2044], 'LK,': [1631, 2045], 'Isselbacher': [1632, 1727, 1813, 1890, 2068], 'EM,': [1633, 1728, 1814, 1891, 2069], 'Kazerooni': [1634, 2052], 'EA,': [1635, 2053], 'Kouchoukos': [1636], 'NT,': [1637], 'Lytle': [1638], 'BW,': [1639], 'DM,': [1641, 2051], 'Reich': [1642], 'DL,': [1643], 'Sen': [1644], 'S,': [1645, 1740, 1934, 1936, 2065, 2113], 'Shinn': [1646], 'Svensson': [1648], 'LG,': [1649], 'Williams': [1650, 2050], 'DM.': [1651, 2020], '2010': [1652], 'ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM': [1653], 'Diagnosis': [1657, 1914, 2141], 'Management': [1659], 'Patients': [1661, 2258, 2405], 'With': [1662, 2259], 'Disease:': [1665], 'Executive': [1666], 'Summary:': [1667], 'Report': [1669], 'Foundation/American': [1676], 'Guidelines,': [1683], 'Surgery,': [1688, 2372, 2424, 2451], 'Radiology,': [1692, 1709], 'Stroke': [1694], 'Association,': [1695, 2519], 'Society': [1696, 1700, 1706, 1710, 1715], 'Cardiovascular': [1698, 1702], 'Anesthesiologists,': [1699], 'Angiography': [1703], 'Interventions,': [1705], 'Interventional': [1708], 'Surgeons,': [1713], 'Vascular': [1717, 2371, 2423, 2450], 'Medicine.': [1718], 'Circulation.': [1719, 1779, 1860, 1902, 2102, 2160], '2010;': [1720], '121:e266–e369.LinkGoogle': [1721], 'Scholar2.': [1722], 'Pape': [1723, 1892], 'LA,': [1724, 1893], 'Tsai': [1725, 1815], 'TT,': [1726, 1816], 'Oh': [1729], 'JK,': [1730], "O'Gara": [1731, 2056], 'PT,': [1732, 2057], 'Evangelista': [1733, 1821, 1872, 2066], 'A,': [1734, 1822, 1873, 2016, 2067, 2109, 2111, 2124], 'Fattori': [1735, 1819, 1866], 'R,': [1736, 1820, 1867, 2128, 2130, 2136, 2237, 2472], 'Meinhardt': [1737], 'G,': [1738, 1938, 2476], 'Trimarchi': [1739, 2112], 'Bossone': [1741, 1884, 2137], 'E,': [1742, 1885, 2138], 'Suzuki': [1743, 2106], 'T,': [1744, 2107, 2172, 2223, 2287], 'Cooper': [1745, 1823, 1876, 2060], 'JV,': [1746, 1824, 1877, 2061], 'Froehlich': [1747, 1827, 2054], 'JB,': [1748, 1828, 2055], 'Nienaber': [1749, 1829, 1864, 2048], 'CA,': [1750, 1865, 2049], 'KA.': [1752, 1895, 2071], '>or': [1755], '=': [1756], 'good': [1762], 'predictor': [1763], 'dissection:': [1768, 1851, 2026], 'observations': [1769], 'Dissection': [1777, 1837, 1858, 2154, 2359, 2411], '(IRAD).': [1778, 1859], '2007;': [1780], '116:1120–1127.LinkGoogle': [1781], 'Scholar3.': [1782], 'Kochanek': [1783], 'KD,': [1784], 'Xu': [1785, 2274], 'J,': [1786, 1887, 2180, 2184, 2225, 2227, 2277, 2295, 2344, 2470], 'Murphy': [1787], 'SL,': [1788, 2122], 'Minino': [1789], 'AM,': [1790, 2043, 2047], 'Kung': [1791], 'HC.': [1792], 'Deaths:': [1793], 'preliminary': [1794], '2009.': [1797], 'Natl': [1798], 'Vital': [1799], 'Stat': [1800], 'Rep.': [1801], '2011;': [1802, 1861, 1979, 2103], '59:1–51.Google': [1803], 'Scholar4.': [1804], 'KM,': [1806, 2063], 'Strauss': [1807], 'CE,': [1808], 'Hirsch': [1811], 'AT,': [1812], 'Shiran': [1817], 'H,': [1818, 1881, 2014, 2293, 2387], 'Montgomery': [1825, 2058], 'DG,': [1826, 2059], 'CAfor': [1830], '(IRAD)': [1838], 'Investigators.': [1839], 'Correlates': [1840], 'recognition': [1843], '124:1911–1918.LinkGoogle': [1862], 'Scholar5.': [1863], 'Mehta': [1868], 'RH,': [1869], 'Richartz': [1870], 'BM,': [1871], 'Petzsch': [1874], 'M,': [1875, 2018, 2115, 2239, 2279, 2332, 2389, 2466, 2482], 'Januzzi': [1878], 'JL,': [1879], 'Ince': [1880], 'Sechtem': [1882], 'U,': [1883], 'Fang': [1886], 'Smith': [1888], 'Gender-related': [1896], 'differences': [1897], '2004;': [1903, 2039], '109:3014–3021.LinkGoogle': [1904], 'Scholar6.': [1905], 'Sullivan': [1906], 'PR,': [1907], 'Wolfson': [1908], 'AB,': [1909], 'Leckey': [1910], 'RD,': [1911], 'Burke': [1912], 'JL.': [1913], 'department.': [1923], 'Am': [1924, 1976], 'J': [1925, 2003, 2300, 2436, 2484], 'Emerg': [1926, 2037], 'Med.': [1927, 2038], '2000;': [1928], '18:46–50.CrossrefMedlineGoogle': [1929], 'Scholar7.': [1930], 'Rosman': [1931], 'HS,': [1932], 'Patel': [1933], 'Borzak': [1935], 'Paone': [1937], 'Retter': [1939], 'K.': [1940, 2140], 'Quality': [1941], 'taking': [1944], 'Chest.': [1950], '1998;': [1951], '114:793–795.CrossrefMedlineGoogle': [1952], 'Scholar8.': [1953], 'Prakash': [1954], 'SK,': [1955], 'Haden-Pinneri': [1956], 'K,': [1957], 'D.': [1959], 'Susceptibility': [1961], 'dying': [1969], 'outside': [1970], 'hospital:': [1972], 'autopsy': [1974], 'study.': [1975], 'J.': [1978], '162:474–479.CrossrefMedlineGoogle': [1980], 'Scholar9.': [1981], 'United': [1982], 'Kingdom': [1983], 'Small': [1984], 'Aneurysm': [1985, 2442, 2498], 'Trial': [1986], 'participants:': [1987], 'long-term': [1988], 'outcomes': [1989], 'immediate': [1991], 'compared': [1993], 'surveillance': [1995], 'small': [1997], 'aneurysms.': [2000], 'New': [2001], 'Engl': [2002], 'Med.2002;': [2004], '346:1445–1452.CrossrefMedlineGoogle': [2005], 'Scholar10.': [2006], 'Hasham': [2007], 'SN,': [2008], 'Lewin': [2009], 'MR,': [2010], 'Tran': [2011], 'VT,': [2012], 'Pannu': [2013], 'Muilenburg': [2015], 'Willing': [2017], 'Nonsyndromic': [2021], 'predisposition': [2023], 'recognized,': [2029], 'diagnosable,': [2030], 'preventable': [2032], 'occurrence': [2033], 'families.': [2035], 'Ann': [2036], '43:79–82.CrossrefMedlineGoogle': [2040], 'Scholar11.': [2041], 'Rogers': [2042], 'Booher': [2046], 'Hutchison': [2064], 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