Aortic Dissection Flashcards
What is the Stanford classification for aortic dissection?
Type A and type B
What is Type A aortic dissection?
Involves the ascending aorta, before the brachiocephalic artery. Associated with chest pain and requires rapid surgical intervention.
What is type B aortic dissection?
Involves the descending aorta post-subclavian artery on the aortic arch and typically presents with back pain. Managed with watchful waiting or thoracic endovascular repair via the femoral.
What is the DeBakey classification of aortic dissection?
Type 1
Type 2
Type 3A
Type 3B
What is Type 1 aortic dissection in Be Bakey’s?
Involves the ascending aorta and can extend to the whole aorta
What is Type 2 aortic dissection in De Bakey’s?
Only involves the aortic arch
What is Type 3A aortic dissection in Be Bakey’s?
Descending aorta above the diaphragm
What is Type 3B aortic dissection in Be Bakey’s?
Descending aorta below the diaphragm
How does aortic dissection present?
Radial pulse is higher in one arm, typically 20 mmHg
Radio-radial delay
Radio-femoral delay
Diastolic murmur due to aortic regurgitation
Syncope
Focal neurological deficits such as paraplegia
What are the complications with aortic dissection?
Stroke
Aortic regurgitation
MI
Paraplegia
Cardiac tamponade
Which medication should be avoided with aortic dissection?
Thrombolytics due to reducing clot formation and increasing the risk of rupture
How is aortic dissection diagnosed?
CXR
CT angiogram or mRI angiogram
What are the risk factors for aortic dissection?
Male
Smoker
Hypertension
Connective tissue disorder
Cocaine use
Bicuspid aortic valve
CABG
Aortic valve replacement
What is the initial management of aortic dissection?
Resuscitation
Blood pressure regulation, ith beta blockers
Cardiac monitoring
Which imaging type is used where proximal dissection is suspected?
Trans-thoracic echocardiograpy is ideal for ascending aorta dissection
What will ECG show for aortic dissection?
ST depression due to ischaemia but may be normal
