Aortic dissection detection risk score (ADD-RS)
Pretest probability of acute aortic dissection.
Inputs
High-risk condition (Marfan or connective tissue disease, family history, known aortic valve disease or aneurysm, recent aortic manipulation)
High-risk pain (abrupt onset, severe, ripping or tearing)
High-risk exam (pulse deficit or BP difference, focal neuro deficit with pain, new aortic regurgitation murmur with pain, hypotension or shock)
Worked calculation
Your values are highlighted.
- Points
When to use
- Chest, back, or abdominal pain, syncope, or perfusion deficit where dissection is possible.
Pearls and pitfalls
- ADD-RS 0 or 1 with D-dimer below 500 ng/mL can rule out dissection (ADvISED trial).
- Score 2 or higher: proceed to aortic imaging.
Why use
Structured dissection risk from the AHA guideline features.
| Criterion | Points |
|---|---|
| High-risk condition (Marfan or connective tissue disease, family history, known aortic valve disease or aneurysm, recent aortic manipulation) | +1 |
| High-risk pain (abrupt onset, severe, ripping or tearing) | +1 |
| High-risk exam (pulse deficit or BP difference, focal neuro deficit with pain, new aortic regurgitation murmur with pain, hypotension or shock) | +1 |