CHAPTER 59 Aortic Dissection and Related Aortic Syndromes Flashcards
TRUE or FALSE: Acute aortic syndromes occur in the setting of acute hypertension
FALSE
Two most common intimal tear sites
sinotubular junction at the start of the acending aorta (50% to 65%)
just beyond the left subclavian artery (20% to 30%) at the junction between the acending and descending aorta. 3
Age distribution of aortic dissection
BIMODAL
1st peak - Younger pxs: (connective tissue disorders)
2nd peak: >50 years with chronic hypertension and/or ischemic heart disease
risk factor for recurrent dissection
Prior aortic dissection
Stanford classification: any involvement of the ascending aorta
type A dissection
Stanford classification: restricted to only the descending aorta
type B dissection
DeBakey classification: simultaneously involve the ascending aorta, the arch, and the descending aorta
type 1 dissection
DeBakey classification: involve ONLY the ascending aorta
type 2 dissection
DeBakey classification: involve ONLY the descending aorta
type 3 dissection
Results from infarction of the aortic media, usually from injury to the vasa vasorum;
may resolve spontaneously or may lead to dissection
Aortic intramural hematoma
TRUE or FALSE: Dissection in or near a carotid artery may present as a classic stroke, and 20% of patients with type A dissection display neurologic findings, which predicts a poorer prognosis
TRUE
TRUE or FALSE: A proximal dissection to the aortic root may lead to cardiac tamponade and is generally fatal.
TRUE
Imaging modality of choice for diagnosis of dissection
CT
Initial treatment should be a _________________ in order to lower blood pressure without increasing the shear force on the intimal flap of the aorta
negative inotropic agent
Ideal B-blockade use
Short-acting (esmolol or labetalol)
