Aortic Dissection

Question 1

What is an aortic dissection?

Answer 1

• Tear in the inner wall of the aorta

Question 2

What causes aortic dissection?

Answer 2

• Blood forces walls of aorta apart

Question 3

What is a Debakey 1 dissection?

Answer 3

• Originates in ascending aorta and propagates

Question 4

What is a debakey 2 dissection?

Answer 4

• Originates and is confined to ascending aorta

Question 5

What is a debakey 3 dissection?

Answer 5

• Originates in descending aorta and can move

Question 6

What is a stanford A dissection?

Answer 6

• Involves ascending aorta and is treated with surgery

Question 7

What is a stanford B dissection?

Answer 7

• Excludes ascending aorta

- Treated medically

Question 8

What is seen on the histology?

Answer 8

• Cystic medial necrosis

Question 9

What is cystic medial necrosis seen as?

Answer 9

• Loss of elastin/muscle fibres

- Accumulation of mucopolysaccharides

Question 10

What can rupturing of an aortic dissection cause?

Answer 10

• Tamponade

Question 11

What are the symptoms of dissection?

Answer 11

• Tearing/severe chest pain

- Radiating to back

Question 12

What can collapse of an aortic dissection lead to?

Answer 12

• Tamponade
• Acute aortic regurgitation
• External rupture

Question 13

What are the signs of an aortic dissection?

Answer 13

• Inferior ST elevation
• Reduced/absent peripheral pulses
• Hypotension/hypertension
• Soft early diastolic murmur
• Pulmonary oedema

Question 14

What are the causes of aortic dissection?

Answer 14

• Hypertension
• Atherosclerosis
• Trauma
• Marfans syndrome

Question 15

What 3 imaging techniques should be used to diagnose aortic dissection?

Answer 15

• CXR
• Echocardiogram
• CT scan

Question 16

What will be seen on a CXR?

Answer 16

• Widened mediastinum

Question 17

What drugs should be used to treat aortic dissection?

Answer 17

• Meticulous BP control (sodium nitroprusside for stanford B)
• B blockers
• Surgery for stanford A