Aortic dissection Flashcards Preview

Year 3: Cardio > Aortic dissection > Flashcards

Flashcards in Aortic dissection Deck (16)
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1
Q

define aortic dissection?

A

a condition where a tear in theaortic intimaallows blood to surge into the aortic wall, causing a split between the inner and outer tunica media, creating afalse lumen

2
Q

how to classify aortic dissection?

A
  • ascending aortic dissection (this is common)

- descending aortic dissection

3
Q

what is the aetiology of an aortic dissection?

A
  • aortic dissections are preceded by degenerative changes in the smooth muscle of the aortic media
4
Q

what are common risk factors for an aortic dissection?

A
  • hypertension
  • aortic atherosclerosis
  • connective tissue disease eg. marfans
  • congenital cardiac abnormalities
  • iatrogenic causes (angiography)
  • trauma
  • crack cocaine
5
Q

what is a dangerous effect of aortic dissection?

A
  • the expansion of the false lumen might result in obstruction of the subclavian, carotid, coeliac and renal arteries.
6
Q

what is the main presenting complaint of aortic dissection?

A
  • sudden central tearing pain radiating to the back in between the shoulder blades.
7
Q

what are the other symptoms of aortic dissection if it obstructs other branches of the aorta?

A
  • carotid artery: hemiparesis, dysphasia, blackout
  • coronary artery: chest pain
  • subclavian artery : ataxia, loss of consciousness
  • anterior spinal artery: paraplegia
  • coeliac artery : severe abdominal pain
  • renal artery :anuria, renal failure
8
Q

how to recognise aortic dissection on physical examination?

A
  • murmur on the back
  • hypertension
  • blood pressure difference between the arms is more than 20mmHg
  • wide pulse pressure
  • unequal arm pulses
  • there could be a palpable abdominal mass
  • there might be signs of aortic regurgitation
9
Q

what might hypotension in aortic dissection suggest?

A

this suggests cardiac tamponade

10
Q

what is pulsus paradoxus?

A

abnormally large decrease insystolic blood pressureandpulse wave amplitudeduringinspiration

11
Q

what might pulsus paradoxus indicate?

A
  • tamponade
  • pericarditis
  • chronic sleep apnoea
  • obstructive lung disease
12
Q

what are the appropriate investigations for aortic dissection?

A
  • bloods
  • chest xray
  • ECG
  • CT thorax
  • echo
  • Cardiac catheterisation and aortography
13
Q

what bloods should be taken for aortic dissection?

A
  • FBC
  • x-match 10 units of blood
  • Us and Es
  • clotting screen
14
Q

what might be seen on a chest x-ray of aortic dissection?

A
  • widened mediastinum
15
Q

what might be seen on a ECG of aortic dissection?

A
  • its often normal
  • if the ostia is damaged you might get
  • left ventricular hypertrophy or inferior MI
16
Q

what might be seen on a CT thorax?

A
  • it could show the false lumen