Aortic dissection

Question 1

Give 2 classification systems for aortic dissection

Answer 1

Stanford
DeBakey

Question 2

Describe the Stanford classification

Answer 2

Stanford A - dissection proximal to the origin of the left subclavian artery (ascending aorta)

Stanford B - dissection distal to the origin of the left subclavian artery (descending aorta)

Question 3

What is the management according to the Stanford classification?

Answer 3

Stanford A - surgical Mx. Target BP systolic 100 - 120

Stanford B - conservative Mx. Manage BP with labetalol IV

Question 4

SSx of aortic dissection

Answer 4

Dissect into carotid arteries - stroke

Dissect into coronary arteries - MI

Dissect into descending aorta - renal failure/limb ischaemia/paraplegia

Unequal arm pulses
Unequal systolic BP