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Communications to the Editor |

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Howard S. Rosman, MD, FCCP; Steven Borzak, MD; Sarine Patel, MD
Author and Funding Information

Henry Ford Heart and Vascular Institute Detroit, MI



Chest. 1999;115(2):606. doi:10.1378/chest.115.2.606
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To the Editor:

We appreciate the comments and the interesting case series described by Drs. Schena, Agnino, and Schinosa in response to our recent report.1 In their series, 154 of 176 patients (88%) with aortic dissection had severe chest pain, while the remaining 22 patients had other symptoms, so that technology played an even more critical role in diagnosis. They conclude that the diagnosis requires “interaction between physicians and machines.” We agree. Our point is that a careful, not lengthy, history is what enables the clinician first to consider and then to order the appropriate test in this catastrophic disorder. Their large series corroborates our finding that the initial history is useful in the vast majority of patients. Even in patients in whom the symptoms were not striking, it was still the history that guided the clinician to the appropriate, often lifesaving, diagnostic test and treatment. We all agree that both physicians and machines are essential in every case for rapid diagnosis of aortic dissection.

Correspondence to: Howard S. Rosman, MD, FCCP, Henry Ford Hospital, Cardiovascular Medicine Division, 2799 West Grand Boulevard, Detroit, MI 48202

References

Rosman, HS, Patel, S, Borzak, S, et al (1998) Quality of history taking in patients with aortic dissection.Chest114,793-795. [PubMed] [CrossRef]
 

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References

Rosman, HS, Patel, S, Borzak, S, et al (1998) Quality of history taking in patients with aortic dissection.Chest114,793-795. [PubMed] [CrossRef]
 
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