Aortic dissection

Question 1

What are some of the causes of aortic dissection?

Answer 1

Hypertension
Trauma
Bicuspid aortic valve
Collagens: Marfan's syndrome, Ehlers-Danlos syndrome
Turner's and Noonan's syndrome
Pregnancy
Syhilis

Question 2

What are some of the symptoms and signs of aortic dissection?

Answer 2

Severe tearing chest pain that radiates through to the back

Aortic regurgitation
Hypertension
May involve symptoms from specific arteries being involved e.g. coronary arteries = angina, spinal arteries = paraplegia, distal aorta = limb ischaemia
Majority of patients have no ECG changes

Question 3

What is the Stanford classification for aortic dissection?

Answer 3

Type A - ascending aorta (2/3 cases)

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

Question 4

What is the management for aortic dissection?

Answer 4

Type A - surgical management but control BP with systolic at 100-120mmHg whilst awaiting intervention

Type B - Conservative management, bed rest and reduce blood pressure with IV labetalol to prevent progression