aortic dissection Flashcards
what
break/tear forms in inner layer of aorta
blood enters been intima and media layers
most common area affected
ascending aorta and aortic arch
Stanford Type A
affects ascending aorta before brachiocephalic artery
Stanford Type B
affects descending aorta after L subclavian artery
DeBakey Type 1
begins in ascending aorta and involves at least the aortic arch
DeBakey Type 2
isolated to ascending aorta
DeBakey Type 3
begins in descending aorta and involves only above diaphragm
DeBakey Type 4
begins descending aorta and involves aorta below diaphragm
risk factors
age male htn smoking, diet bicuspid aortic valve AV replacement aortic coarctation CABG MArfan's syndrome Ehler's danlos syndrome
presentation
tearing chest pain, radiate to back hypertension BP diff between arms radial pulse defici diastolic murmur collapse focal neuro deficit hypotension as progresses
Diagnosis
CT angiogram
MRI angiogram
Mx
surgical emergency
analgesia
HR and BP control - beta blockers
Type A surgery
open surgery - midline sternotomy
Type B surgery
thoracic endovascular repair (TEVAR)
complications
MI stroke paraplegia cardiac tamponade AV regurg death
