The patient with chest pain

Question 1

Which investigation should be ordered to confirm a diagnosis of aortic dissection?

Answer 1

CT angiography - shows intimal flap in aorta

Question 2

What are the two types of aortic dissection?

Answer 2

Type A - involves the ascending aorta, more acutely life-threatening
Type B - does not involve the ascending aorta, mortality lower at 10-20%

Question 3

After discharge from hospital, what medications should a patient with aortic dissection be started on?

Answer 3

Antihypertensives: Metoprolol and/or enalapril

Question 4

What are the ECG criteria for primary percutaneous coronary intervention (pPCI) in acute coronary syndrome?

Answer 4

ST elevation in 2 continuous leads or LBBB
AND
cardiac sounding chest pain