Aortic Dissection
This is suspected aortic dissection, and CT angiography confirms it.
Aortic Dissection
- Intimal tear → blood enters media → false lumen
- Type A: Involves ascending aorta → surgical emergency
- Type B: Descending only → medical management
- Presents: Tearing/ripping chest pain radiating to back , unequal BP in arms
- Associated with: HTN ( 1), Marfan, bicuspid aortic valve, syphilis
Read this in Comprehensive Heart Pathology Notes 🫀
What our notes say
- This is suspected aortic dissection, and CT angiography confirms it. (Cardiology Question Bank: 15 Clinical MCQs)
- Aortic dissection and pre-eclampsia are exceptions with their own targets. (Hypertension)
- | Hypertensive emergency | Very high BP with acute organ damage (encephalopathy, pulmonary oedema, aortic dissection, acute kidney injury, eclampsia) | (Hypertension)
- Acute, severe → myocardial ischaemia, pericarditis, aortic dissection, PE (most common causes) (CVS History & Physical Exam: Symptoms, Chest Pain & Syncope)
- Aortic dissection — severe tearing pain, front or back of chest, abrupt onset (unlike crescendo ischaemic pain) (CVS History & Physical Exam: Symptoms, Chest Pain & Syncope)
- A 55-year-old patient with uncontrolled hypertension presents with an aortic dissection. (Chemical Pathology MCQs: Clinical Chemistry, Endocrine & Renal)
Study material on Aortic Dissection
Practice questions on Aortic Dissection
35-year-old male, Marfan syndrome, aortic dissection ascending aorta to iliacs. Which layer does the dissection plane travel through?
- Within the adventitia
- Within the outer third of the media
- Between the media and adventitia
- Through the full thickness of the aortic wall
- Between the intima and media (subintimal)
Answer: B. - Marfan-associated dissection results from **cystic medial degeneration** (loss of elastin/smooth muscle, mucoid pools) - The dissection plane classically splits within the **outer third of the media** ---
A 35-year-old male with Marfan syndrome presents with sudden severe back pain. CT angiography reveals aortic dissection extending from the ascending aorta to the iliac arteries. The dissection plane travels through which layer of the aortic wall?
- Between the intima and media (subintimal)
- Within the outer third of the media
- Between the media and adventitia
- Within the adventitia
- Through the full thickness of the aortic wall
Answer: B. Aortic dissection involves a tear in the intima, allowing blood to enter and propagate within the medial layer, creating a false lumen.