- Section 1 Patients and their treatment
- Section 2 Background to medicine
- Section 3 Cell biology
- Section 4 Immunological mechanisms
- Section 5 Principles of clinical oncology
- Section 6 Old age medicine
- Section 7 Pain and palliative care
- Section 8 Infectious diseases
- Section 9 Sexually transmitted diseases
- Section 10 Environmental medicine, occupational medicine, and poisoning
- Section 11 Nutrition
- Section 12 Metabolic disorders
- Section 13 Endocrine disorders
- Section 14 Medical disorders in pregnancy
- Section 15 Gastroenterological disorders
- Section 16 Cardiovascular disorders
- 16.1 Structure and function
- 16.2 Clinical presentation of heart disease
- 16.3 Clinical investigation of cardiac disorders
- 16.4 Cardiac arrhythmias
- 16.5 Cardiac failure
- 16.6 Valvular heart disease
- 16.7 Diseases of heart muscle
- 16.8 Pericardial disease
- 16.9 Cardiac involvement in infectious disease
- 16.10 Tumours of the heart
- 16.11 Cardiac involvement in genetic disease
- 16.12 Congenital heart disease in the adult
- 16.13 Coronary heart disease
- 16.14 Diseases of the arteries
- 16.14.1 Acute aortic syndromes
- 16.14.2 Peripheral arterial disease
- 16.14.3 Cholesterol embolism
- 16.15 The pulmonary circulation
- 16.16 Venous thromboembolism
- 16.17 Hypertension
- 16.18 Chronic peripheral oedema and lymphoedema
- 16.19 Idiopathic oedema of women
- Section 17 Critical care medicine
- Section 18 Respiratory disorders
- Section 19 Rheumatological disorders
- Section 20 Disorders of the skeleton
- Section 21 Disorders of the kidney and urinary tract
- Section 22 Haematological disorders
- Section 23 Disorders of the skin
- Section 24 Neurological disorders
- Section 25 Disorders of the eye
- Section 26 Psychiatric and drug-related disorders
- Section 27 Forensic medicine
- Section 28 Sport and exercise medicine
- Section 29 Biochemistry in medicine
- Section 30 Acute medicine
(p. 3674) Diseases of the arteries
The acute aortic syndromes are acute dissection, intramural haematoma, and penetrating ulcer, and all involve disruption of the wall of the aorta with potentially devastating consequences. Although relatively uncommon, left unrecognized and untreated they can carry a mortality rate of up to 2% per hour and 50% within the first few weeks. Physical signs typically reflect the region of the aorta involved and effects of pressure on adjacent structures: evidence of new aortic regurgitation or development of pulse deficits should be actively sought. Abnormalities on the chest radiograph and ECG are common, but neither investigation is diagnostic and further imaging is always necessary by MRI, contrast-enhanced CT, or transoesophageal echocardiography, depending on local availability and the clinical condition of the patient. In the long term, strenuous efforts to control blood pressure are indicated for all patients who have survived aortic dissection, with repeat imaging at least once a year.
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- Section 1 Patients and their treatment
- Section 2 Background to medicine
- Section 3 Cell biology
- Section 4 Immunological mechanisms
- Section 5 Principles of clinical oncology
- Section 6 Old age medicine
- Section 7 Pain and palliative care
- Section 8 Infectious diseases
- Section 9 Sexually transmitted diseases
- Section 10 Environmental medicine, occupational medicine, and poisoning
- Section 11 Nutrition
- Section 12 Metabolic disorders
- Section 13 Endocrine disorders
- Section 14 Medical disorders in pregnancy
- Section 15 Gastroenterological disorders
- Section 16 Cardiovascular disorders
- 16.1 Structure and function
- 16.2 Clinical presentation of heart disease
- 16.3 Clinical investigation of cardiac disorders
- 16.4 Cardiac arrhythmias
- 16.5 Cardiac failure
- 16.6 Valvular heart disease
- 16.7 Diseases of heart muscle
- 16.8 Pericardial disease
- 16.9 Cardiac involvement in infectious disease
- 16.10 Tumours of the heart
- 16.11 Cardiac involvement in genetic disease
- 16.12 Congenital heart disease in the adult
- 16.13 Coronary heart disease
- 16.14 Diseases of the arteries
- 16.14.1 Acute aortic syndromes
- 16.14.2 Peripheral arterial disease
- 16.14.3 Cholesterol embolism
- 16.15 The pulmonary circulation
- 16.16 Venous thromboembolism
- 16.17 Hypertension
- 16.18 Chronic peripheral oedema and lymphoedema
- 16.19 Idiopathic oedema of women
- Section 17 Critical care medicine
- Section 18 Respiratory disorders
- Section 19 Rheumatological disorders
- Section 20 Disorders of the skeleton
- Section 21 Disorders of the kidney and urinary tract
- Section 22 Haematological disorders
- Section 23 Disorders of the skin
- Section 24 Neurological disorders
- Section 25 Disorders of the eye
- Section 26 Psychiatric and drug-related disorders
- Section 27 Forensic medicine
- Section 28 Sport and exercise medicine
- Section 29 Biochemistry in medicine
- Section 30 Acute medicine