Aortic Dissection

Question 1

Definition

Answer 1

Tear in the intimate layer of Aortic wall

Question 2

Types

Answer 2

Stanford:
Type a - ascending aorta involved (more of an emergency)
Type b - ascending aorta not involved

Question 3

Clinical features

Answer 3

Tearing chest pain

Hypotension

Tachycardia

Aortic regurgitation murmur

Question 4

Investigations

Answer 4

Bloods: FBC, U+Es, LFTs, coagulation, troponin

Bedside: ABG, ECG

Imaging: CTangiogram, transoesophageal echo

Question 5

Management

Answer 5

Urgent initial assessment and resuscitation

Type a = transfer to cardiothoracic centre (remove ascending aorta to replace with synthetic graft)

Type b = manage hypertension. If chronic then endovascular repair

Question 6

Complication

Answer 6

Aortic rupture

Aortic regurgitation

Myocardial ischaemia secondary to coronary artery dissection

Cardiac Tamponade