Aortic dissections | The University Of Western Ontario - Edubirdie

University:
The University Of Western Ontario
Course:
Biology 2290F | Scientific Method in Biology
Academic year:

2022
Views:

135

Pages:

3
Author:

Kyuwon J.

Aortic dissections ● Tear in intimal layer in aorta ○ Blood enters into the media creating false lumen ○ Could be critical and is considered a vascular emergency ● Classifications ○ Stanford ■ Type A ● Involvement of ascending aorta (could have descending) ● Surgical emergency ■ Type B ● Involvement of descent aorta only ● Distal to left subclavian ● Medical management ○ Unless compilation is seen ○ DeBakey ■ Type 1 ● Ascending ⇒ entire aorta ■ Type 2 ● Ascending only ■ Type 3 ● Descending only ● Risk factors ○ Hypertensions ■ Most common ■ Disorder of connective tissues ● Marfan ● Ehler-Danlos ○ Bicuspid aortic valve ○ Coaractation on aorta ○ Cocain ■ Sympathomimetic ○ Pregnancy ■ In the 3rd trimester ○ Trauma ● Pathophysiology ○ Internal tear ⇒ high pressure forces blood to flow into media ⇒ splitting in longitudinal direction ■ Will create true lumens ■ Two false lumens ● Compresses arterial branches ○ Organ ischemia ● Clinical features ○ Pain ■ abrupt , severe ● tearing , ripping pain ○ Type A ■ Anterior chest pain ○ Type B ■ Intercapsular back pain ● Vital signs + CVS ○ Hypertension in early stage ○ Shock in late stages ○ Pulse deficits ■ Asymmetrical Blood pressures ■ Early diastolic murmurs ○ Will have similar smx to cardiac tamponades ■ Heypotensions ■ JVD ■ Muffled heart sounds ○ Complications ■ Coronary artery involvement ⇒ MI ■ Cerebral ischemia ⇒stroke ■ Renal mesenteric ⇒ ischemia

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