aortic dissection

Question 1

aortic dissection

Answer 1

tear in the tunica intima of the wall of the aorta

Question 2

associations

Answer 2

hypertension: the most important risk factor
trauma
bicuspid aortic valve
collagens: Marfan’s syndrome, Ehlers-Danlos syndrome
Turner’s and Noonan’s syndrome
pregnancy
syphilis

Question 3

symptoms of aortic dissection

Answer 3

chest pain: typically severe, radiates through to the back and ‘tearing’ in nature, aortic regurgitation, hypertension

Question 4

classification of aortic dissection

Answer 4

stanford classification - type A or B

DeBakey- type I-III

Question 5

investigations for aortic dissection

Answer 5

CXR- widening mediastinum

CT angiography- fulse lumen

Question 6

management of aortic dissection

Answer 6

surgical
conservative management
bed rest
reduce blood pressure IV labetalol to prevent progression

Question 7

Complications of backward tear

Answer 7

aortic incompetence/regurgitation

MI

Question 8

Complications of a forward tear

Answer 8

unequal arm pulses and BP
stroke
renal failure