Aortic Dissection + Hypertension

Question 1

Sign of Aortic Dissection?

Answer 1

Sudden ripping chest pain, may radiate to back.

Question 2

Type A aortic dissection?

Answer 2

Originates in ascending aorta

Question 3

Type B aortic dissection?

Answer 3

Originates in descending aorta

Question 4

Investigations for aortic dissection?

Answer 4

1) ECG
2) CXR, TOE, CT
3) MRI (confirm)

Question 5

Initial Management for aortic dissection?

Answer 5

1) Crossmatch 10U blood
2) Refer to ITU
3) IV beta blockers

Question 6

Surgical Management Type A aortic dissection?

Answer 6

Complete graft, possible arch of aorta replacement

Question 7

Surgical Management Type B aortic dissection?

Answer 7

Thoracic Endovascular Aortic Repair + optimized medical treatment.

Question 8

Signs of Hypertension?

Answer 8

High BP, check for retinopathy/renal disease.

Question 9

What is ABPM?

Answer 9

24hr home BP monitoring

Question 10

Staging of Hypertension?

Answer 10

1) >140/90 OR ABPM >138/85
2) >160/100 OR ABPM >150/95
Severe: >180/110

Question 11

Drug Management of Hypertension

Answer 11

1) ACEi/ARB or Ca blocker
2) Add other one
3) Thiazide diuretic
4) Spironolactone or alpha/beta blocker