aortic dissection

Question 1

what are the symptoms of aortic dissection ?

Answer 1

severe central tearing chest pain (really bad) that may radiate through the back

sudden onset

may mimic renal colic

collapse

Question 2

risk factors for AD ?

Answer 2

having an AAA (lol)

being a man

being old

being a smoker

being obese

having a FHx of AAA

having Marfan’s

hypertension, hyperlipidaemia, atherosclerosis

Question 3

what are the two classifications for AD ?

Answer 3

Stanford and DeBakey

Question 4

what is the stanford classification ?

Answer 4

standford type A = aortic dissection in the ascending aorta

standford type B = descending aorta (this one has no end-organ ischaemia)

Question 5

management for standford type B ?

Answer 5

medical ie

IV beta blockade, analgesia

maybe vasodilators to bring HPT down

Question 6

management for standford type A ?

Answer 6

open replacement / endovascular intervention

before = BP should be controlled, with a target of 100-120mmHg

Question 7

what is the DeBakey classification ?

Answer 7

type I - originates in the ascending aorta, and moves distally

type II - originates and is confined to the ascending aorta

type III - originates in the descending aorta

Question 8

investigations for AD ?

Answer 8

CXR - widened mediastinum

CT angiography - false lumen

Question 9

complications of AD ?

Answer 9

backwards tear:
aortic regurgitation

MI - inferior/right coronary

forwards tear:
unequal arm pulses and BP

stroke

renal failure