Pitfalls

Dismissing AAD from the differential diagnosis because the pain is in the anterior chest
Dismissing the diagnosis of AAD because the patient does not have differential pulses or blood pressures
Excluding AAD because the patient has pain for only a short period or has no pain at all
Not appreciating that migratory pain is highly specific for AAD
Not performing a second ‘definitive’ investigation if the first is negative in a patient with a high clinical suspicion of AAD
Not adequately controlling elevated blood pressure in patients with AAD
Using vasodilators alone in the management of blood pressure in patients with AAD.