75. Aortic dissection

Question 1

3 RFs for dissection

Answer 1

1. male
2. Age
3. HTN
4. bicuspid aorta

Question 2

Layer dissection occurs

Answer 2

media

Question 3

stanford classes

Answer 3

1. A - ascending

2. B - descending

Question 4

Deadly triad of dissections

Answer 4

1. No CP
2. Hypotension
3. Branch vessel involvment

Question 5

ECG findings of dissection

Answer 5

1. MI pattern

2. LVH due to long term HTN

Question 6

6 CXR findings

Answer 6

• Mediastinal widening
• Double density of aorta
• Localized bulge
• Disparity in caliber of ascending and descending
• Obliteration of aortic knob
• Displacement of trachea or NG to Right

Question 7

2 main goals of MGMT

Answer 7

1. reduce BP (100-120)

2. reduce HR <60

Question 8

2 main meds to use

Answer 8

1. Esmolol
   o 500ug/kg bolus, then 200ug/kg infusion
2. Labetolol
   o 20mg bolus q5-10min