Aortic dissection

 

Overview

Aortic dissection occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart.

Discussion

1. How do you describe the pain that occurs in aortic dissection?

Sudden severe chest or upper back pain, often described as a tearing or ripping sensation

The location of pain is associated with the location of the dissection

2. Why does aortic dissection occur?

Aortic dissection is caused because of weakened area in the wall of aorta

3. Why does Marfan syndrome increase the risk of aortic dissection?

Marfan syndrome is a condition in which connective tissue (which supports various structures in the body) is weak. In Marfan syndrome blood vessel wall strength is affected so people with this disorder often have a family history of aortic aneurysm and aortic dissection

4. What are the 2 types of aortic dissection?

Stanford Type A

This type of dissection occurs in the first part of the aorta(ascending aorta) which is closer to the heart

Stanford Type B

This type of tear begins further down the aorta (descending aorta) which is farther from the heart

5. Can aortic aneurysm lead to aortic dissection?

Yes. Aortic aneurysm can lead to aortic dissection 

6. Why is aortic dissection more common in ascending aorta than in descending aorta?

This happens because the blood pressure is the highest in ascending aorta. Tears in the aorta typically occur in areas where the stress on the wall of the aorta is highest.

7. How is aortic dissection treated?

For Stanford type A (ascending aortic dissection), surgical management is superior to medical management.

For uncomplicated Stanford type B (distal aortic dissection) medical management is preferred over surgery.

Complicated Stanford type B aortic dissections require surgical intervention after initiation of medical therapy.

8. What is the role of beta blockers in treating aortic dissection?

Beta blockers lower down the blood pressure and heart rate