Arterial Dissection

Question 1

Define arterial dissection

Answer 1

Disruption to intimal layer of aorta
Blood cannot pass through vital channel
Channel of blood through weak area of wall = expansion of wall = aneurysm

Question 2

Causes

Answer 2

Spontaneous = patient with HTN, calcification
Trauma
Iatrogenic = doctor surgery

Question 3

Presentation of aortic dissection

Answer 3

• tearing
• central chest pain
• radiates to the back
• absent pulses as certain branches not perfused
• previous repair of aortic root

Question 4

RF of aortic dissection

Answer 4

HTN
CT disease
Bicuspid aortic valve
Marfans

Question 5

Diagnosis of aortic dissection

Answer 5

CT

CXR poor diagnosis

Question 6

CXR signs

Answer 6

Arch of aorta unfolded out

Less air on left lung parenchyma

Question 7

CT signs

Answer 7

Window seen
Can see dissection line
2 bulges of blood flow

Question 8

Types

Answer 8

Stanford A = proximal to L subclavian artery, closer to coronary arteries closing them off = sudden cardiac death. high mortality without immediate surgery
Stanford B = dissection distal to L subclavian artery, strict BP control and monitor, may need surgery if blood supply to vital organs (gut, kidney ischaemia) affected