History taking for suspected acute aortic syndrome: other predictors outside the aortic dissection detection risk score bundle?

In patients with clinical suspicion of acute aortic syndrome (AAS), guideline-based pre-test risk assessment primarily evaluates twelve key factors among predisposing conditions (Marfan syndrome/other connective tissue disease, family history of aortic disease, aortic valve disease, recent aortic manipulation, or thoracic aortic aneurysm), pain features (abrupt onset, severe intensity or ripping/tearing quality of pain) and physical exam findings (pulse asymmetry/systolic blood pressure differential between extremities, focal neurological deficit, murmur of aortic insufficiency or shock state/hypotension), summarized in the aortic dissection detection risk score (ADD-RS)