What is the initial diagnostic test for a stable patient suspected of having an aortic dissection?

In the context of diagnosing aortic dissection in a stable patient, spiral CT angiography is considered the initial diagnostic test of choice due to its speed, availability, and ability to provide detailed images of the aorta. This imaging modality offers high sensitivity and specificity for detecting both the presence and extent of the dissection, as well as any potential complications such as aortic rupture or involvement of branch vessels.

Spiral CT angiography can quickly obtain images of the thoracic and abdominal aorta, making it particularly advantageous in emergency care settings where timely intervention is crucial. This rapid imaging technique not only helps confirm the diagnosis but also assists in planning subsequent management approaches.

Other options, while relevant in certain contexts, are either less preferred or not the best initial choice. MRI is highly sensitive for aortic pathologies but is less practical in acute settings due to longer acquisition times and limited accessibility in emergency situations. Chest X-ray can sometimes show indirect signs of dissection but is not definitive and often requires further imaging for confirmation. Ultrasound is useful for certain clinical scenarios but is generally not the primary diagnostic tool for aortic dissection, particularly in evaluating the thoracic aorta. Therefore, spiral CT angiography stands out as the optimal first step in a stable