Contents

Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Show Summary Details
Page of

Aortic dissection 

Aortic dissection
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2022. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 01 July 2022

Aortic dissection represents a splitting apart of the layers of the aortic wall, with blood under pressure entering the dissection plane and propagating for long distances along the aorta. The pain is said to be the most severe that a human being can experience. Pain is felt substernally with ascending dissection and between the shoulder blades for descending dissection. A high degree of clinical suspicion is essential in order for the diagnosis not to be missed. Because the dissection process can impair any branch of the aorta, the patient may present with symptoms related to any organ in the body. D-dimer is 100% sensitive at detecting aortic dissection (but non-specific). The ‘Triple Rule-Out CT Scan’ can confirm the clinical suspicion of aortic dissection, while at the same time ruling-out the other two cardiac conditions that can take a patient’s life acutely. Ascending dissection (Type A) is a surgical emergency because of the likelihood of intra-pericardial rupture. Descending dissection (Type B) is usually treated medically (with ‘anti-impulse’ therapy with β‎-blockers and afterload reducers). This condition is highly litigated and lethal if missed on initial presentation. Using D-dimer and liberal imaging will prevent mis-diagnosis and save lives.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.