Aortic Dissection

Overview

  • This is where there is pathology in the lumen of the aorta
  • A break in the lumen causes blood to flow between the layers of the wall of the aorta
  • This creates a false lumen in the aorta (a space where blood is contained within the wall of the aorta
  • Most commonly affects around the ascending aorta and aortic arch, but can affect any part of the aorta
  • This is a surgical emergency

 

Risk Factors

Are the same as peripheral arterial disease with the addition of:

  • Ehlers-Danlos Syndrome
  • Marfan’s Syndrome

 

Presentation

  • Tearing chest pain of sudden onset
  • Radiating to the back
  • Hypertension
  • Hypotension (as the dissection becomes more severe)

 

Management

  • Resuscitation
  • Confirmation by immediate imaging (Ultrasound, CT or MRI angiogram)
  • Urgent vascular input and surgical repair
  • Manage hypertension (beta blockers)
  • Urgent surgical stenting or repair (time critical – each passing hour increases mortality)
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