Aortic dissection occurs after a tear in the intima allows blood to enter the media and dissect between the intimal and adventitial layers, creating a false lumen which may extend anterograde or retro..
Aortic dissection occurs after a tear in the intima allows blood to enter the media and dissect between the intimal and adventitial layers, creating a false lumen which may extend anterograde or retrograde - Incidence: 2.6-3.5 per 100,000 person, bimodal age distribution - Risk factors: long-term HTN or connective tissue disorders (most common), preexisting aneurysm, bicuspid aortic valve, aortic coarctation, cocaine use - Classic presentation: tearing/ripping sensation, severe pain, pulse deficit, aortic regurgitation, tamponade -Painless dissection has been reported, although relatively uncommon (6.4% in one retrospective study) -Type A: ascending aorta – surgical tx -Type B: descending aorta – medical tx -Dx: CT w/ contrast -Acute Tx: reduce RATE first, then lower BP - Esmolol or Labetalol, Nitroprusside
