Aortic Dissection Flashcards
1
Q
What is an aortic dissection?
A
- when a break or tear forms in the tunica intima of the aorta
- blood entered between intima + media layers of aorta forming a false lumen
2
Q
Most common location of aortic dissection
A
Right lateral area of ascending aorta
3
Q
Classification systems of aortic dissection
A
Stanford system
DeBakey system
4
Q
Stanford system of aortic dissection
A
- type A: affects ascending aorta before brachiocephalic artery
- type B: affects descending aorta after left subclavian artery
5
Q
DeBakey system of aortic dissection
A
- type I: begins in ascending aorta involves aortic arch
- type II: isolated to ascending aorta
- type IIIa: begins in descending aorta above diaphragm
- type IIIb: begins in descending aorta below diaphragm
6
Q
Risk factor of aortic dissection
A
- male
- smoking
- hypertension most common
- Hyperlipidaemia
- cocaine use
- heavy weight lifting
- bicuspid aortic valve
- Marfan’s + Elhers-Danlos
7
Q
Conditions or procedures that increase risk of aortic dissection
A
- bicuspid aortic valve
- coarctation of aorta
- aortic valve replacement
- CABG
- Marfan’s + Ehlers Danlos syndrome
8
Q
Presentation of aortic dissection
A
- sudden onset, severe, ripping chest pain
- anterior pain if ascending aorta
- posterior pain if descending aorta
- collapse
- radial pulse deficit
- new aortic regurgitation murmur (early diastolic murmur)
9
Q
Diagnosis of aortic dissection
A
CT angiogram (first line)
MRI angiogram
10
Q
Management of aortic dissection
A
- IV morphine
- BP+HR well controlled - B blockers
- type A: open surgery + replacement of synthetic graft
- type B: thoracic endovascular aortic repair
11
Q
Complications of aortic dissection
A
- MI
- stroke
- paraplegia
- cardiac tamponade
- aortic valve regurgitation
- death
12
Q
Layers of arterial wall
A
Tunica intima
Tunica media
Tunica externa
