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