Week 4 - Aortic Dissection Flashcards
what is aortic dissection
- tearing of the inner layer of the aorta
= blood surges thru the tear causing layers of the vessel to separate
what can cause aortic dissection
- degeneration of the elastic fibres in the medial layer
- -> HTN
what does aortic dissection cause
- cut off blood supply to critical areas such as the brain, kidneys, spinal cord, extremities
what are predisposing factors to aortic dissection (6)
- HTN
- age
- male sex
- CHD
- CT disorders
- atherosclerosis
what signs are seen in an ascending aortic dissection (3)
- sudden, severe onset of excruciating chest pain, back pain, or both
- pain radiates to back or soulder
- sharp, ripping, tearing, pain
where is pain seen in a descending aortic dissrection (2)
- pain to back, abdomen, legs
if the aortic arch is involved in the dissection, what signs will you see (5)
- neuro deficits
- altered LOC
- weakened or absent carotid & temporal pulses
- dizziness
- syncope
an ascending aortic dissection produced disrupted blood flow to??
- the coronary arteries
a descending aortic dissection produces disrupted blood flow to?? (2)
- abdominal organs
- lower extremities
an aortic dissrection involving the aortic arch will cause disrupted blood flow to??
- the brain (= emergency)
what are 3 complications of aortic dissection
- cardiac tamponade
- aortic rupture
- occlusion of blood supply to organs
how does aortic dissections lead to cardiac tamponade
- when blood flow the dissection leaks into the pericardial sac
what are clinical manifestations of cardiac tamponade (4)
heart not pumping well due to pressure on heart:
- hypotension
- narrowed pulse pressure
- jugular venous distension
- muffled heart sounds
how can aortic dissection lead to aortic rupture
- if it is weakened by the dissection
what does aortic rupture lead to
- hemorrhage into the mediastinal, pleural, or abdominal cavities
= exsanguination and death
an aortic dissection can lead to occlusion of blood supply to which organs (4)
- spinal cord,
- kidneys
- brain
- the mesentry
what are symptoms of spinal cord iscemia (3)
- weakness
- decreased sensation to lower extremities
- paralysis of lower extremities
what can renal ischemia lead to
- renal failure
what are symptoms of abdominal (mesentry) ischemia (4)
- abdominal pain
- decreased BS
- altered bowel fnxn
- bowel necrosis
what diagnostics can be used to diagnose aortic dissection (4)
- chest xray
- CT
- transesophageal echo (TEE)
- MRI
what are the initial goals of therapy for aortic dissection (2)
- BP control
- pain control
why is BP control imp for aortic dissection
- reduces stress on aortic wall
what is the other goal of treatment of aortic dissection
- prevent rupture and progression of dissection
what are different types of treatment for aortic dissection (3)
- conservative therapy (BP and pain control, if no complications)
- endovascular dissection reapir
- surgery
