Aortic Dissection Flashcards
What is the consequence of a tear in the tunica intima of the aorta?
Separation of layers within the aortic wall, potentially leading to aortic rupture
What are the classifications of aortic dissection according to the Stanford Classification?
Type A: Involves the ascending aorta, potentially causing cardiac tamponade.
Type B: Involves all dissections except those of the ascending aorta, potentially leading to end-organ ischemia.
List risk factors associated with aortic dissection.
Preexisting aortic aneurysm, advanced age, male gender, hypertension, and use of amphetamines or cocaine.
What are the clinical signs of aortic dissection?
Sudden sharp pain in upper back and shoulders, weak pulse, unequal blood pressure between arms, and aortic regurgitation murmur.
Which imaging modality is used to diagnose aortic dissection and what does it reveal?
CT angiography; reveals true and false lumens and assesses organ perfusion, with a false lumen indicating dissection.
What is the immediate management approach for Type A (proximal) aortic dissections?
Immediate surgical repair, typically through open laparotomy or thoracic endovascular aortic repair (TEVAR), involving removal of dissected aorta and reconstruction with a graft.
How is Type B (distal) aortic dissection managed?
Managed with beta blockers, such as bisoprolol, to decrease blood pressure, velocity, and left ventricular contraction.
What complications are associated with aortic dissection?
Pericardial tamponade, haemorrhaging, compression of branching arteries (e.g., renal or subclavian), shock, SUDDEN DEATH
What is always the first initial step?
beta blocker always
What should be requested as soon as the diagnosis is suspected?
contrast-enhanced computed
What causes a radical femoral delay?
aortic dissection type B
What causes a radical radial delay
aortic dissection type A
