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Flashcards in general Deck (40)
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1

definition

catastrophic tear of tunica intima letting luminal blood under high pressure into tunica media...

tunnels a second lumen

2

definition

catastrophic tear of tunica intima letting luminal blood under high pressure into tunica media...

tunnels a second lumen

3

Type A aortic dissections involve

ascending aorta and/or arch (and commonly more of the aorta)

4

Type B dissections involve

descending aorta alone

5

Type A vs. Type B

Type A is more common and more serious

6

Progression

intermittent
go proximally or distally

7

are dissections unique to the aorta?

no! they can occur in other arteries

8

Epidemiology

uncommon
late middle age
males
blacks

9

Associated with...

HTN

Marfan Syndrome or late pregnancy (younger pts)

10

Pathogenesis

1. starts with intimal tear
----caused by trauma or surgery or something not obvious
2. dissection of hemorrhage into lumen?

11

motor vehicle accidents with deceleration can cause

intimal tear at the ligamentum arteriosum

12

rupture of vasa vasorum in some cases..

may cause hemorrhage in wall and dissection of this hemorrhage into the lumen may be the next step

13

vasa vasorum

arteries within artery

14

medial dissection commonly associated with..

cystic medial degeneration

15

Type A symptoms

sudden severe sharp "tearing" chest pain
***Anteriorly**
moving as the dissection progresses

arm pain and weakness if subclavian artery compromised

altered mental status (if carotid is hit)

collapse (if it ruptures)

lack of pain is uncommon

16

Type B symptoms

sudden severe sharp "tearing chest pain
***Between the scapula****
moving as the dissection progresses

rest of symptoms may be same as Type A

17

Complications

rupture (commonly into pericardium; less often into pleural cavity)

occlusion of aortic branches

aortic valve regurgitation

death

18

Diagnosis

requires imaging with transesophageal echocardiogram, computerized tomography, or magnetic resonance imaging

19

Treatment includes

reducing BP to low normal
--beta-blockers and vasodilator therapy

TYPE A
--surgery

20

When would type B require surgery?

only if:
a rupture is impending,
major aortic branches are compromised, or
dissection is progressing

21

Aortic dissection

medical or sometimes surgical EMERGENCY!

22

Type A aortic dissections involve

ascending aorta and/or arch (and commonly more of the aorta)

23

Type B dissections involve

descending aorta alone

24

Type A vs. Type B

Type A is more common and more serious

25

Progression

intermittent
go proximally or distally

26

are dissections unique to the aorta?

no! they can occur in other arteries

27

Epidemiology

uncommon
late middle age
males
blacks

28

Associated with...

HTN

Marfan Syndrome or late pregnancy (younger pts)

29

Pathogenesis

1. starts with intimal tear
----caused by trauma or surgery or something not obvious
2. dissection of hemorrhage into lumen?

30

motor vehicle accidents with deceleration can cause

intimal tear at the ligamentum arteriosum