Skip to main content

Aortic Dissection

Javier Ayo, MD, Jessica A. Ryder, MD and John Kiel, DO, MPH Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Disruption of the media layer of the aorta with bleeding within the wall resulting in separation of aortic layers. Accumulating blood in false lumen of arterial wall leads to propaga...

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

Initial goals include management of pain, limi...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • In the acute setting, maintain systolic BP at ≤120 mm Hg, as tolerated (1),(3)[C].

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

REFERENCES

1
Thrumurthy SG, Karthikesalingam A, Patterson BO, et al. The diagnosis and management of aortic dissection. BMJ.  2011;344:d8290. [View Abstract on OvidMedline]
2
Hiratzka LF, Bakris GL,...

ADDITIONAL READING

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

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...

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 ...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

 
×