Consider aortic dissection as a potential cause of acute ischemic stroke or STEMI.Follow the management approach of the suspected condition.Patients with critical organ dysfunction Īortic dissection can present as a mimic of another time-dependent life-threatening condition, e.g., ACS, CVA, or pulmonary embolism. Confirm hypotension by measuring blood pressure in a second limb. Admit to critical care unit or transfer to OR.Īn initial low blood pressure reading in a limb could be falsely low due to an intimal flap obstructing its blood supply.Consider definitive imaging (e.g., CTA) if the patient is stabilized, in consultation with a specialist.Consider additional consultations: e.g., cardiology, critical care.Immediately treat life-threatening complications, e.g., immediate hemodynamic support, management of cardiac tamponade.Perform simultaneous bedside investigations, e.g., ECG, portable CXR, and/or bedside echocardiography ( TEE, TTE, or POCUS) based on availability.Resuscitate with ACLS and/or stabilize using ABCDE approach.Patients may present with shock or cardiac arrest due to complications of aortic dissection, e.g., aortic rupture, acute coronary syndrome, cardiac tamponade, acute aortic regurgitation. Ĭonsult cardiothoracic surgery for all patients with highly suspected or confirmed aortic dissection, regardless of Stanford classification. The optimal management approach depends on the clinical presentation, e.g., acute aortic syndrome. Type IIIa: limited to the descending thoracic aorta above the level of the diaphragm.Most cases can be managed by medical therapy.Dissections originate in the descending aorta and most often extend distally.Dissections originate in, and are restricted to, the ascending aorta.Dissections originate in the ascending aorta and continue to at least the aortic arch but typically as far as the descending aorta.Stanford A = Affects ascending aorta Stanford B = Begins beyond brachiocephalic vessels DeBakey classification (rarely used) Most cases can be managed with medical therapy (e.g., beta blockers, vasodilators).Descending aorta originating distal to the left subclavian artery.Stanford type B aortic dissection: any dissection not involving the ascending aorta. ![]() Complications include aortic regurgitation and cardiac tamponade. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |