Thoracic Aortic Dissection

Question 1

Aortic Dissection?

Answer 1

Blood splits in the aortic media with sudden tearing chest pain +/- radiation to the back.

Question 2

2 types of dissection?

Answer 2

Type A and B

Question 3

which type occurs in 70% of pts?

what part of aorta does it involve?

Tx?

Answer 3

Type A

ascending aorta irrespective of tear site

all pts should be considered for surgery with cardiothoracic advice

Question 4

which type occurs in 30% of patients?

what part of aorta does it involve?

Tx?

Answer 4

Type B

doesn’t involve ascending aorta

Tx is less clear - can be medically managed w/ surgery reserved for distal dissection thats are leaking/compromising vital organs.

Question 5

Symptoms of aortic dissection

Answer 5

Unequal arm pulses + BP in arms
Acute limb ischaemia
Hemiplegia (one sided paralysis) - carotid artery
Paraplegia - waist down parlaysis - anterior spinal artery
Anuria (renal arteries )
I

Question 6

Tx of aortic dissection?

Answer 6

Crossmatch 10 units of blood
CT/TOE echo
Take to ITU