Aortic dissection overview

Aortic dissection Microchapters
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Case #1

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Aortic dissection is a tear in the wall of the aorta that causes blood to flow between the layers of the wall of the aorta and force the layers apart. Aortic dissection is a medical emergency and can quickly lead to death, even with optimal treatment. If the dissection tears the aorta completely open (through all three layers) massive and rapid blood loss occurs. Aortic dissections resulting in rupture have a 90% mortality rate even if intervention is timely.

Acute aortic dissection is the most common fatal condition that involves the aorta. The mortality rate has been estimated to be as high as 1% per hour during the first 48 hours. Because of the diverse clinical manifestations of aortic dissection, one needs to maintain a high index of suspicion in patients with not just chest pain, but also those with stroke, congestive heart failure, hoarseness, hemoptysis, claudication, superior vena cava (SVC) syndrome, or upper airway obstruction. Despite the fact that a noninvasive diagnosis can be made in up to 90% of cases, the correct antemortem diagnosis is made less than 50% of the time. Recognition of the condition and vigorous pre-operative management are critical to survival.

Acknowledgements

The content on this page was first contributed by: David Feller-Kopman, MD and C. Michael Gibson M.S., M.D.