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Aortic Dissection

Kevin D Nguyen, Doctor of Medicine (MD) Reviewed 04/2024
 


BASICS

DESCRIPTION

  • A tear in the aortic intima and disruption of the media layer with bleeding into the wall, resulting in separation of aortic layers  (1). Accumulating blood in false lumen of arteria...

DIAGNOSIS

HISTORY

  • A high level of clinical suspicion is essential. Sudden onset, severe chest or back pain is the most common presenting symptom. Although classically described as “tearing” in nature, ...

TREATMENT

GENERAL MEASURES

The primary goal is limiting the extension of dissection by minimizing aortic shear stress in the form of blood pressure control (4)[C]. Other initial goals include managemen...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Prior to discharge, thoracic MRI or chest CT scan should be obtained and followed at 1, 3, 6, and 12 months, and then yearly to assess for compl...

REFERENCES

1
MacGillivray TE, Gleason TG, Patel HJ, et al. The Society of Thoracic Surgeons/American Association for Thoracic Surgery clinical practice guidelines on the management of type B aortic dis...

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

SNOMED

  • 308546005 dissection of...

CLINICAL 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 ...

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