Aortic dissection Flashcards
What is aortic dissection
Dissection occurs when a tear in the tunica intima of the aorta creates a false lumen where blood can flow between the inner and outer layers of the heart
Risk factors
HTN, connective tissue disorders, valvular heart disease, cocaine and amphetamine use
Classification of aortic dissection
A = ascending aorta, B = descending aorta
Presentation of aortic dissection
Sudden onset tearing chest pain or intrascapular pain radiating to the back. Can present with syncope
Which population does it typically affect
Men over 50 years age
What can aortic dissection cause to other organs
Bowel or limb ischaemia and renal failure
Examination findings in aortic dissection
Radio-radial delay, radio-femoral delay, BP arm difference
Method to diagnose aortic dissection
CT angiogram
ECG of patient with aortic dissection
ischamic territories
ECHO of patient with aortic dissection
Pericardial effusion and aortic valve involvement
CXR of patient with aortic dissection
Widened mediastinum
Bloods of aortic dissection
Troponin may be raised and D-dimer may be positive or negative
Initial management of patient with aortic dissection
Resus, cardiac monitoring, strict BP control with IV metoprolol
Management of classification A
Surgical management
Management of classification B
Conservatively with BP control
