Diagnosis and Management of Aortic Dissection in a Pediatric Patient With Turner Syndrome: A Simulation

• Published in: Curēus (Palo Alto, CA) Vol. 15; no. 7; p. e41725
• Main Authors: Attridge, Megan M, Hopkins, Kali A, Mangold, Karen, Brickman, Wendy J, Patel, Sheetal R
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 11-07-2023; Cureus
• Subjects: Aortic dissection; Blood pressure; Cardiac arrhythmia; Cardiology; Caregivers; Coronary vessels; Educational objectives; Electrocardiography; Emergency medical care; Emergency Medicine; Genetic disorders; Heart rate; Hypertension; Medical diagnosis; Mortality; Narcotics; Pain; Patients; Pediatrics; Point of care testing; Pulse oximetry; Simulation; Surgeons; Ultrasonic imaging; Vital signs; aortic dissection diagnosis; chest pain in the young; pediatric emergency & acute care; aortic dissection management; simulation medicine; simulation training; pediatric clinical cardiology; aortic dissection; turner syndrome
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.41725

Aortic dissection is exceedingly rare in the pediatric population. However, it is much more common among children and adolescents with certain underlying syndromes, including Turner syndrome. Furthermore, aortic dissection carries significant mortality without prompt diagnosis and management. Therefore, pediatric emergency providers should know how to recognize and treat pediatric aortic dissection in a patient with Turner syndrome. We designed this simulation for pediatric emergency medicine fellows. A simulated adolescent female patient with a known history of Turner syndrome presents with chest pain, tachycardia, and hypertension. Participants must order and interpret the appropriate diagnostics, diagnose aortic dissection, and manage aortic dissection adequately. This simulation was completed by six pediatric emergency medicine fellows and one pediatric resident. After completing the simulation, six participants (85.7%) provided anonymous feedback on a five-point Likert scale (one = strongly disagree, five = strongly agree). Feedback was positive, and participants agreed that the case content was relevant to their clinical practice and that the event will improve their clinical practice. This simulation encourages participants to recognize and manage pediatric aortic dissection in patients with Turner syndrome. Participants felt that the simulation was relevant and will improve their clinical practice.