USMLE/COMLEX - Step 2 - Aortic dissection
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USMLE/COMLEX - Step 2 - Aortic dissection
What is the pathophysiology of an aortic dissection?
Tear in the intima of a vessel that causes blood to enter the media, which creates a false lumen and longitudinal hematoma
List the risk factors of aortic dissection
Hypertension
Coronary artery disease
Smoking
Marfan syndrome
Mitral valve prolapse
Trauma
Which risk factor is most common?
Hypertension
What symptoms will the patient present with?
Tearing chest pain that may or may not radiate to the back
How is an aortic dissection diagnosed?
If the patient is unstable: Transesophageal echocardiography
If the patient is stable: CT angiogram
How is it treated?
Stanford type A (ascending aorta) dissection: immediate surgery
Stanford type B (descending aorta) dissection: IV labetalol followed by nitroprusside