ECG, Chest X-ray, CT scan with 3-D Reconstruction, Transesophageal echocardiogram, MRI
Pain relief: opioids
Blood Transfusion (If necessary)
IV B-adrenergic blockers
IV Calcium channel blockers
Surgical aortic resection and repair
Endovascular aortic dissection repiar
Anatomical Position: Ascending v Descending Aorta
Duration: Acute v Chronic
approximately two-thirds of dissections involve the ascending aorta and are acute in onset
Tear inner layer of aorta
Blood surges into the middle layer
inner and middle layers to separate
• Degenerated elastic fibers in the arterial wall
• Chronic Hypertension hastens this process
• Inherited/Acquired connective tissue disorders causing abnormal vascular ECM
• Blunt trauma
• Cocaine/methamphetamine use
• History of heart surgery
• Male gender
Affects men 2-5 times more often than women and occurs more frequently in the 6th and 7th decades of life
• Abrupt onset of excruciating chest and/or back pain radiating to the neck or shoulders
• Pain located in the back, abdomen or legs
• Pain is frequently described as "sharp" and "worst ever," or as "tearing," "ripping" or "stabbing"
• Neurologic deficits
• May develop angina
• Abdominal Organs & Lower Extremities = decreased tissued perfusion
• Cardiac Tamponade
• Aortic rupture
Occlusion of blood supply to vital organs
Femoral and popliteal aneurysms: are not common. Are often associated with aneurysms in other locations.
• Observe for a pulsating mass over the femoral artery. Assess for a pulsating mass in the popliteal space. Evaluate both extremities.
• S/S: limb ischemia, diminished or absent pulses, cool-cold skin, pain.
• Regardless of size surgery is recommended because of the risk of clots.
• Palpate pulses below the graft to assess graft patency. Report sudden development of pain.