Aortic dissection

Definition- Tunica media and adventitia form false lumen

Acute- <14 days

Type

1.Stanford- Type A(Ascending aorta, ⅔ ), Type B(Not involve ascending aorta, ⅓ )

2.Debakey- Tpe I(Ascending and descending), Type II(Ascending), Type III(Descending)

Etiology- HTN, Marfan, Artherosclerosis, CoA, trauma, Pregnancy 3rd trimester

Presentation- Chest tearing pain, back pain, diaphoresis, dyspnea

Complication- Coronary(AMI), Aortic valve(HF), CCA(stroke), Vertebral artery(paraplegia), Renal artery(AKI), iliac artery(Lower limb numbness), Cardiac tamponade(Beck’s triad, pulsus paradoxus, Kussmaul’s sign)

X-ray- Mediastinum wideing

Management

1.Acute Type A- Surgery

2.Acute Type B- Complicated(Surgery), Uncomplicated(Anti-impulse therapy)

3.Chronic Type A and B- Anti-impulse therapy(If>5 cm surgery)

*Anti-impulse therapy- Esmolol + Nitroprusside, Control HR60~80, SBP120, MAP80

Published by Steve Johnson

I am a doctor who like to organise knowledges and share ideas with others. As a doctor, a lot of knowledges influx everyday and need some patient to organise and absorb. Here was my notes to share with you and hope to save your time to know it.

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