Aortic dissection

Question 1

What is the stanford classification for aortic dissection

Answer 1

Type A - occurs in ascending aorta 2/3 of cases

Type B - descending aorta, distal to left subclavian origin , 1/3 of cases

Question 2

How does a patient with aortic dissection present

Answer 2

Acute severe chest pain
- more common in type A whereas typ B has back pain

deficit pulse
aortic regurgitation
left/right blood pressure differential

features of marfan or Ehlers- Danlos syndromes

Question 3

What symptoms may someone present with due to the blocking of branching arteries

Answer 3

Carotid - blackout, dysphagia
Coronary - angina
Subclavian - loss of consciousness
Renal - anuria, renal failure

Question 4

What are risk factors for an aortic dissection

Answer 4

hypertension
trauma
bicuspid aortic valve
coarctation of aorta
connective tissue disorders

Question 5

What investigations are required for an aortic dissection

Answer 5

CT ANGIOGRAM- false lumen which is formation of a new channel between 2 layers as results of aortic dissection

ECG- often normal

CXR- widened mediastinum

Bloods and cardiac enzymes

Question 6

What is management for aortic dissection

Answer 6

IV antihypertensives and beta blocker
Oxygen and analgesia

Question 7

How do you manage a Type A aortic dissection

Answer 7

surgery
control BP to 100-120 systolic

Question 8

How do you manage a Type B aortic dissection

Answer 8

conservative management
IV labetalol to reduce BP