Aortic Dissection

Question 1

what are the layers of an artery wall from inner to outer

Answer 1

tunica intima (inner)
tunica media (middle)
tunica adventitia (outer)

Question 2

what is an aortic dissection

Answer 2

tear in the tunica intima causing blood to flow between + splitting apart of tunica intima + media

Question 3

timescale for an

• acute aortic dissection
• chronic aortic dissection

Answer 3

acute - diagnosed <14 days

chronic - diagnosed >14 days

Question 4

what disorders increase risk of aortic dissection

Answer 4

marfans

ehlors danlos

Question 5

risk factors for aortic dissection

Answer 5

HTN
atherosclerosis
biscupid aortic valve

Question 6

presentation of aortic dissection

Answer 6

tearing chest pain that radiates to back

• tachycardia
• hypotension
• new aortic regurgitation murmur

Question 7

imaging for a dissection

Answer 7

CT angiogram

Question 8

difference between type A and type B aortic dissections

Answer 8

Type A involve ascending aorta

Type B start at origin of left subclavian

Question 9

management of a type A dissection

Answer 9

surgical

• carry a high mortality
• transfer to cardiothoracic centre
• removal of ascending aorta + replacement with synthetic graft

Question 10

management of type B dissection

Answer 10

medical

• manage HTN with IV labetalol (ca channel blockers 2nd line)
• EVAR if aneurysm formation