Sandbox vidit
| Suspected aortic dissection | |||||||||||||||||||||||||||||||||||||||||||||
| ❑ Look for the following cardinal signs & symptoms: ❑ Sudden onset chest pain (tearing/ripping/sharp or stabbing) ❑ Asymmetric blood pressure in extremities ❑ Shock ❑ Pulse deficit ❑ Evolving aortic regurgitation murmur | |||||||||||||||||||||||||||||||||||||||||||||
Unstable patient | Stable patient | ||||||||||||||||||||||||||||||||||||||||||||
Order urgent TTE Look for the following high risk features: ❑ Pericardial effusion ❑ Regional wall motion abnormality (RWMA) ❑ Dilated root ❑ Aortic regurgitation (AR) | Continue with diagnostic approach | ||||||||||||||||||||||||||||||||||||||||||||
❑ Aortic dissection confirmed
❑ Transfer to Cardio-thoracic unit ❑ Perform TEE in CCU or cardiac OR | |||||||||||||||||||||||||||||||||||||||||||||
❑ Proceed to surgery | |||||||||||||||||||||||||||||||||||||||||||||
Look for the following: Intimal flap and tear
Intimal entry
Mobile linear flap in short axis view
Small central true lumen communicating with false lumen