Aure-Rozanova's sign

Aure-Rozanova's sign is a clinical sign associated with certain medical conditions, particularly those affecting the cardiovascular system. It is named after the physicians who first described it. This sign is considered significant in the diagnosis and assessment of diseases such as aortic dissection and other conditions that may lead to compromised blood flow to the upper extremities.

Definition

Aure-Rozanova's sign is characterized by a discrepancy in blood pressure readings between the arms. Specifically, it is observed when there is a significant difference in systolic blood pressure measurements of 20 mmHg or more between the right and left arms. This phenomenon suggests the presence of an obstruction or a significant narrowing in the major arteries supplying blood to the arms, most commonly due to an aortic dissection or a similar pathology affecting the aortic arch.

Clinical Importance

The presence of Aure-Rozanova's sign is an important diagnostic clue that warrants further investigation. It is particularly relevant in the emergency setting where rapid identification of conditions like aortic dissection is critical for patient survival. Aortic dissection is a life-threatening condition that requires immediate medical intervention, and Aure-Rozanova's sign can be one of the early indicators suggesting this diagnosis.

Diagnosis

To diagnose the underlying cause of Aure-Rozanova's sign, healthcare professionals may employ a variety of diagnostic tools. These include:

- Blood pressure monitoring: Repeated measurements to confirm the discrepancy in blood pressure between arms. - Echocardiography: An ultrasound of the heart to assess the aortic root and ascending aorta for signs of dissection or other abnormalities. - Computed tomography angiography (CTA): A specialized CT scan that provides detailed images of the blood vessels, particularly useful for identifying aortic dissection. - Magnetic resonance angiography (MRA): An MRI study focused on the blood vessels, offering an alternative to CTA for patients with contraindications to iodinated contrast.

Treatment

The treatment for conditions indicated by Aure-Rozanova's sign depends on the underlying cause. In the case of aortic dissection, immediate surgical intervention or endovascular repair may be necessary to prevent catastrophic outcomes. Management strategies for other conditions leading to this sign will vary based on the specific diagnosis and patient factors.

Conclusion

Aure-Rozanova's sign is a critical clinical observation that can guide the diagnostic process in patients with suspected cardiovascular abnormalities. Its identification necessitates prompt and thorough evaluation to determine the underlying cause and initiate appropriate treatment.