If there is a sudden tearing pain that moves from the chest to the back and down to the lower back, call 120 (China's ambulance number) and say clearly that "the pain is moving"

Top value
Evidence B
Buys life
Free
Takes minutes
No willpower

In a real emergency, call 911 first, then read this.

In plain words

If a tearing pain moves from the chest to the back and down to the lower back, say directly when you call 120 (China's ambulance number): "it feels like tearing, and the pain is moving downward." Without surgery, with medicine alone, the death rate for this illness is 58%. The treatment is the opposite of a heart attack: only if the doctor thinks of it will they do a contrast CT scan, instead of giving blood thinners or clot-dissolving drugs. If the blood pressure differs a lot between the two arms, or the pulse can't be felt on one side, say that too.

Cost: Free.
What you get: The International Registry of Acute Aortic Dissection (IRAD) enrolled 464 cases from 12 centers. Aortic dissection is the illness with tearing pain in the chest and back. Among the symptoms patients reported first, the most common was a sudden severe sharp pain. The overall death rate in hospital was 27.4%. For type A dissection treated with medicine alone and no surgery, the death rate was 58%
Notes: The treatment of dissection is exactly the opposite of that of a heart attack. A heart attack is treated with anticoagulants and clot-dissolving drugs, which keep blood from clotting, and using them on a dissection is like letting blood out of the tear. So on arrival at the hospital, say on your own initiative "tearing pain, the pain is moving downward," so the doctor thinks of checking a contrast CT. A big blood pressure difference between the two arms, or a pulse that can't be felt on one side, is a hint. People with poorly controlled blood pressure, people with Marfan syndrome, and people whose family has had an aortic aneurysm or dissection are at higher risk. Likewise, don't drive yourself, and don't put up with it until the next day
Evidence grade: B : Supported by research but without a precise number, or based on small or single studies.
Sources: Hagan PG, Nienaber CA, Isselbacher EM, et al. (2000). The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA, 283(7), 897-903. https://doi.org/10.1001/jama.283.7.897

Translated from the Chinese original. Original book, section 13, tip 8. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer