37 Aortic Dissection
typora-copy-images-to: ./images
Aortic Dissection
Pathogenesis
- intima right next to blood
- can spread distally to abdomen or proximally toward heart
- type A mortality very high, surgery to correct, replace with graft
- HTN drives blood into false lumen
Symptoms
- stretch aortic valve: regurge
- dissection obstructs blood flow to one arm
- mediastinum: 1
Diagnosis
- clots form after blood get into dissection
- contrast CT
- top: aorta
- dissection flap: piece of tissue in middle. Blood broken through layers of aorta and separated aorta
- True lumen: bigger one
- false lumen: space inside flap
- type A:
Risks
- aortic dissection requires tension on wall and weakness of media layer
- HTN leads to thick vasa vasorum
- Marfans, Eherlos Danlos
- aortopathy: abnormal aorta, in bicuspiad aortic valve and marfan
Complications
Aortic Aneurysms
Thoracic
- often identified by screening
Abdominal
- almost always occur in association with atherosclerosis
- above bifurcation, below renal arteries
Aortic Rupture
- tear through all 3 layers
- elasticity in proximal portion
- rigid in descending portion
Backlinks