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Lecture notes

Aortic dissection

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This document contains all the relevant student knowledge pertaining to aortic dissection. This includes: Relevant anatomy Pathophysiology Classification Symptoms Diagnosis Management

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  • December 18, 2022
  • 6
  • 2022/2023
  • Lecture notes
  • Caitlin austin
  • All classes

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Def Result of tear ulceration in the wall of the aorta
a or
resulting
in an intimal flap between the true lumen and the new false lumen

Haemorrhage then occurs
into this false lumen

7 14 finerlayer
outer
pay
ft The dissection
may rip
stops at points of atherosclerosis
down the aorta It
usually


M W Proximal lesions so
ggy o
S 3 1 000,000 Distal 60 70 lo
y
B w w y


Causes
Most common A there sclerosis Causes a
plaque in the
aortic wall wall weakness The plaque then ruptures
tear in tunica intima false lumen in media

H TN Exaggerates dilation of the aorta weakness


3
Inherited Cause
younger populations Marfan's
in
Ehlers Danlos polycystic kidneys


Trauma Particularly blunt chest trauma
e.g RTAs

, S
Iatrogenic Cardiac catheterization



Inflammatory disorders Takayasu's aorta arteritis

Giant cell arteritis Behcet's disease



Symptoms
Male
Typically an pt
Sudden chest pain Radiates to the back scapula
very severe
Most often sharp or
tearing
Syncope dyspnoea


Signs
Tachycardia
Hyper of Hypo tension
Weak unequal pulses 401
Diastolic murmur of Aortic
regurg as the valve becomes
involved


Initial investigations
ECG The pt present with chest pain so an
will
ACS or MI is ruled out before considering dissection


CX R Can rule out alternative causes of chest pain
but show the classic widened mediastinum of
may

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