Aortic dissection Flashcards

1
Q

Is AAA or aortic dissection more common?

A

aortic dissection 3x more common

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2
Q

What are the risk factors for aortic dissection

A

HTN, cocaine, bicuspid aortic valve, smoking, cardiac surgery, connective tissue disorders

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3
Q

What happens in aortic dissection?

A

intima tears and blood fills layers between it and media

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4
Q

How is dissection diagnosed?

A

CT angiogram

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5
Q

How is Stanford classification divided?

A
Type A: dissection involves the ascending aorta with or without involvement of the arch and descending aorta. Accounts for 60-70% of cases.
Type B (TBAD): Involves only the descending aorta (distal to the left subclavian artery) and/or abdominal aorta. Accounts for 30-40% of cases
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6
Q

Describe three complications of aortic dissection

A

aortic rupture
MI

cardiac tamponade
acute aortic regurg
Renal failure
Bowel ischaemia
Acute limb ischaemia
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7
Q

List two signs of dissection on CT

A
  1. Double lumen (true and false lumens) thus confirming the diagnosis of AAD
  2. The entry tear (where the dissection begins)
  3. Any evidence of aortic dilatation (aneurysmal change)
  4. Evidence of end-organ malperfusion (for example non-enhancing kidney)
  5. Features of acute rupture (including extravasation of contrast or haemothorax)
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8
Q

What are the indications for surgery in aortic dissection?

A

Type A or retrograde type B
Persistent pain
Aortic rupture
Extension despite optimal medical management

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