Cardiac 07 Aortic Dissection Flashcards
What is an aortic dissection?
It’s the separation of the aortic wall between the intima and adventitia.
What’s the time period between an acute dissection and a chronic dissection?
Acute dissection <14 days.
What is a Type A Aortic Dissecetion?
Involves ascending aorta. Could involve the descending as well. Typically occurs in pt w/ congential weakening of ascending aorta. Accounts for 2/3 dissections
What is a Type B Aortic Dissection?
Occurs only at the descending aorta distal to L subclavian artery. Typically occurs in odler patient populations w/hx HTN and atherosclerosis .
Aortic Dissection usually has pain not relieved with pain meds. Where are 3 areas where pain may occur.
- Chest pain (sharp): retrosternal, interscapsular. common w/ ascending dissections.
- Severe flank pain: more with descending dissections
- Epigastric pain: more common with descending dissections
What BP meds would you use in treating AD?
- alpha and beta blockers: Labetalol
- Calcium Channel Blocker: nicardipine
What’s the difference between surgeries in ascending and descending dissections?
Ascending: cardiopulmonary bypass needed, done surgically.
Descending: aortic cross clamp needed. Surgery usually avoided d/t high mortality. Surgery recommended when aortic diameter > 5cm. A stent and balloon fenestration has been done w/success for descending dissections.
What’s the most common type of aortic dissection?
Type A occurs in 2/3
What’s the demographic of Type B dissections?
Older pt, hx HTN, atherosclerosis
Delete
Info. Aortic dissections is considered the great imitator because it has symptoms of other issues
chest pain: MI
Severe flank pain:
epigastric pain: GERD?
Dissections has pain that is not relieved with analgesics
What is the quickest way to dx aortic dissections?
TEE. Not as helpful in viewing descending aorta and branches though
Med tx of dissections?
labetalol and nicardipine
for pain, morphine
