Aortic Dissection

Question 1

what classification systems are used in aortic dissection?

Answer 1

• stanford
• DeBakey

Question 2

what is type A stanford aortic dissection?

Answer 2

ascending aorta (~2/3rd of cases)

Question 3

what is type B stanford aortic dissection?

Answer 3

descending aorta (~1/3rd of cases)

Question 4

what is seen on chest x-ray in aortic dissection?

Answer 4

widened mediastinum

Question 5

what is the investigation of choice for aortic dissection?

Answer 5

CT angiography of the chest, abdo and pelvis

Question 6

what is seen on CT angiography of CAP in aortic dissection?

Answer 6

false lumen

Question 7

what investigation is performed in patients unable to have a CT in aortic dissection?

Answer 7

transoesophageal echocardiography (TOE)

Question 8

what is the management of type A aortic dissection?

Answer 8

• hypertensive control with IV labetalol
• surgical repair = thoracic endovascular aortic repair

Question 9

what is the target systolic BP for type A aortic dissection?

Answer 9

100-120 mmHg

Question 10

what is the management for type B aortic dissection?

Answer 10

• conservative
• bed rest
• IV labetalol to prevent progression

Question 11

what are the possible complications of a backwards tear in aortic dissection?

Answer 11

• aortic incompetence/regurgitation
• MI = inferior pattern (due to right coronary involvement)

Question 12

what are the possible complications of a forward tear in aortic dissection?

Answer 12

• unequal arm pulses and BP
• stroke
• renal failure