Aortic Dissection

Question 1

Aortic Dissection Definition

Answer 1

Separation of aortic wall layers forming true and false lumina with or without communication
-Acute, subacute, chronic

Question 2

Aortic Dissection Epidemiology

Answer 2

Most common in men, 50-70, rare below 40

Question 3

Aortic Dissection RFs

Answer 3

Hypertension, smoking, cholesterol, FHx

Question 4

Aortic Dissection Classification

Answer 4

Stanford Classification

• Type A involves ascending
• Type B does not involve ascending

Question 5

Aortic Dissection Presentation

Answer 5

• Chest pain, aortic regurgitation, myocardial ischaemia, CHF, pleural effusion, syncope, neurological symptoms
• Often presents in two phases
• After a first event with severe pain and pulse loss, bleeding stops
• Second event when pressure exceeds critical limit and rupture occurs
• Typical patient is man in 60s with hypertension and sudden onset CP
• Ripping pain
• Pain is sudden onset and worst at first unlike MI

Question 6

Aortic Dissection Differentials

Answer 6

ACS, aortic regurgitation, aneurysms, pericarditis, MSK

Question 7

Aortic Dissection Ix

Answer 7

Distinguish from MI

-ECG, imaging

Question 8

Aortic Dissection Management

Answer 8

IV access, analgesia, transfer to HDU, manage hypertension, BBs, surgery