Aortic Dissection

Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Classically an intimal tear in the aorta resulting in hematoma formation. Accumulating blood in false lumen of arterial wall leads to propagation of a dissection. Alternatively, it m...

DIAGNOSIS

HISTORY

  • A high level of clinical suspicion is essential.

  • A typical patient is a hypertensive male aged 60 to 80 years unless coexisting connective tissue disorders are present.

  • A positive famil...

TREATMENT

Due to the acute nature of an aortic dissection, there are no randomized controlled trials related to treatment and management. 

GENERAL MEASURES

Patients should be monitored in an intensive c...

ONGOING CARE

FOLLOWUP RECOMMENDATIONS

MONITORING

  • Maintain systolic BP at ≤120 mm Hg, as tolerated. β-Blockers are first-line (1,3,7)[C].

  • Prior to discharge, thoracic MRI or chest CT scan should be obtain...

REFERENCES

Thrumurthy SG, Karthikesalingam A, Patterson BO et al. The diagnosis and management of aortic dissection. BMJ.  2011;344:d8290. [View Abstract on OvidInsights]
Hiratzka LF, Bakris GL,...

ADDITIONAL READING

Nair HC. Transesophageal echocardiography evaluation of thoracic aorta. Ann Card Anaesth.  2010;13(2):186. [View Abstract on OvidInsights] 

SEE ALSO

Ehlers-Danlos Syndrome; Hypertension, Essential; Hypertension, Secondary and Resistant; Marfan Syndrome 

CODES

ICD10

  • I71.00 Dissection of unspecified site of aorta

  • I71.01 Dissection of thoracic aorta

  • I71.03 Dissection of thoracoabdominal aorta

  • I71.02 Dissection of abdominal aorta

ICD9

  • 441.00 Dissection of aort...

PEARLS

  • Acute pain is reported by 90% of patients with aortic dissections. The pain is more often sharp but may be tearing and is located in the chest, abdomen, or back. Maintain a high level of suspic...

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