ITV Granada featured the news of Paula Ivers this evening, bringing renewed attention to the ongoing challenge of recognising aortic dissection in emergency care.
Paula was a 47-year-old children’s nurse and mother from Greater Manchester. Her sister, Lesley, who is also a nurse, has worked to raise awareness following Paula’s death and to ensure that lessons are learned from what happened.
For the Aortic Dissection Charitable Trust, stories such as Paula’s are difficult to hear but important to share. Behind every missed diagnosis is a life that has been changed. They also remind us why our work with emergency medicine clinicians, researchers and patients must continue.
What Happened to Paula
Paula attended the Emergency Department at Tameside General Hospital in 2024 after experiencing increasing chest pain that radiated into her back.
Following triage and an ECG, her care was transferred to the hospital’s Same Day Emergency Care unit. She was assessed, underwent a chest X-ray and blood tests, and was later discharged with a diagnosis of gastroesophageal reflux disease. She was given medication and advised to follow up with her GP.
The possibility of a thoracic aortic dissection was not considered during her assessment, and a CT angiogram was not undertaken. Paula died at home three days later.
A post-mortem examination found that she had died from a haemopericardium caused by an aortic dissection. Her inquest concluded in June 2026, with the coroner recording that Paula died from complications arising from an undiagnosed and therefore untreated aortic dissection. The coroner concluded that neglect contributed to her death.
The Prevention of Future Deaths report went further. It stated that, had a CT angiogram been undertaken, it was likely that Paula’s underlying condition would have been identified. This could have led to transfer to a specialist centre for emergency surgery, which the coroner said she probably would have survived.
Learning From Paula’s Death
The coroner expressed concern about how patients are directed between Emergency Departments and Same Day Emergency Care services. In particular, the report highlighted the absence of a national requirement for an early substantive face-to-face review by an experienced doctor or Advanced Practitioner before a patient is streamed into another urgent care service.
There were also specific concerns relating to the assessment of patients presenting with chest pain at the hospital trust. These included whether important family history, such as the early cardiac death of an immediate family member, is captured reliably and whether blood pressure should routinely be measured in both arms.
These may sound like individual parts of an assessment, but aortic dissection is often diagnosed by bringing together several pieces of information. Symptoms, medical history, family history, examination findings and clinical judgement can all influence whether a clinician considers acute aortic syndrome and whether further imaging is needed.
A Continuing Challenge in Emergency Departments
Aortic dissection is uncommon compared with many other causes of chest, back or abdominal pain, and patients do not always present in the same way.
That complexity is important to acknowledge. Improving diagnosis does not mean that everyone presenting with chest pain should automatically have a CT angiogram. The challenge is giving clinicians better evidence, education and decision-making tools so they can reliably identify patients who need urgent imaging.
Missed and delayed diagnosis remains one of the biggest challenges in improving outcomes from acute aortic dissection. That is why the charity continues to work closely with emergency medicine professionals to improve recognition and investigation of the condition. Earlier this month, we partnered with the Royal College of Emergency Medicine for a national education meeting focused specifically on diagnosing acute aortic dissection in the Emergency Department. The programme covered clinical decision-making, D-dimer, point-of-care ultrasound, biomarkers, artificial intelligence, cognitive bias and emerging national guidance.
The aim is not to make an already pressured Emergency Department more complicated. It is to help create practical approaches that support clinicians when a patient presents with symptoms that could have several possible causes.
Paula’s Story Is Not the First
Sadly, Paula’s experience is not an isolated reminder of the consequences of delayed diagnosis.
In 2025, ITV Granada also covered the story of David Burgess, another patient from Greater Manchester. David attended hospital with severe abdominal and back pain and was initially diagnosed with gastritis. He returned to hospital several days later and was diagnosed with an aortic dissection. Despite emergency surgery, he died in May 2025.
Every patient’s circumstances are different, and individual cases should not be treated as interchangeable. Stories like Paula’s and David’s show why aortic dissection must remain in the differential diagnosis when the history and presentation raise concern.
Families sharing these experiences perform an important public service. Their stories put a human face on diagnostic statistics and give healthcare professionals an opportunity to understand where the patient journey can break down.
Turning Patient Stories into Practical Change
Raising awareness is only part of the charity’s response.
The Aortic Dissection Charitable Trust is investing in research designed to give clinicians better tools at the point where difficult diagnostic decisions are made. Our research programme includes work on artificial intelligence, bedside echocardiography and biomarkers, as well as a project exploring the development of a diagnostic blood test for acute aortic dissection.
We also bring lived experience directly into medical education. Patients and bereaved family members share what happened to them with emergency clinicians, medical students and other healthcare professionals. These accounts help connect clinical decision-making with what it feels like to be the person seeking help when something is seriously wrong.
Alongside research and education, we continue to support work on clearer diagnostic pathways and better systems of emergency aortic care. The recently published Aortic Window framework, developed with the charity’s involvement, looks at how the whole pathway from Emergency Department arrival through diagnosis, referral, transfer and surgery can be organised around the time-critical nature of the condition.
No single change will solve the problem of missed aortic dissection. Progress comes from combining better evidence, better education, better pathways and the experiences of patients and families who can show us where systems need to improve.
Keeping Aortic Dissection on the Agenda
The attention ITV Granada gives Paula’s family gives them an opportunity to raise awareness of a condition many people still know very little about.
It also keeps an important patient safety issue in public view.
Emergency clinicians work in extraordinarily demanding environments and routinely assess people with symptoms that could represent many different conditions. Our role as a charity is to work alongside the medical community, not simply to highlight where things have gone wrong. By supporting research, education and system improvement, we want to make it easier for clinicians to recognise aortic dissection and for patients to reach specialist treatment quickly when it occurs.
Paula’s family should not have had to experience this loss for these questions to be asked. Their determination to share her story now gives healthcare services another opportunity to learn from it.
We are grateful to Lesley and the Ivers family for helping bring attention to aortic dissection, and to ITV Granada for giving this important issue a wider platform.
Bereavement Support
Stories involving sudden loss or a missed diagnosis can be particularly difficult for people who have experienced something similar. If you have lost somebody to aortic dissection, survived the condition yourself or have questions about the care you or a loved one received, the Aortic Dissection Charitable Trust is here to support you.
Our free resources include information for patients and families, bereavement support and guidance for people who have questions about the care they received. We can also help signpost you towards appropriate organisations and professional support.
