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Aortic Dissection: Presentation By: Hafeez LC CVT Intern

Aortic dissection is a syndrome caused by a tear in the Intima, leading to the formation of a false lumen and is classified into Type A and Type B according to the Stanford classification. Risk factors include long-standing hypertension and connective tissue disorders, with symptoms such as sudden pain and potential complications like stroke. Management options include medical management for uncomplicated cases and endovascular therapy using stent grafts for treatment.

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5 views23 pages

Aortic Dissection: Presentation By: Hafeez LC CVT Intern

Aortic dissection is a syndrome caused by a tear in the Intima, leading to the formation of a false lumen and is classified into Type A and Type B according to the Stanford classification. Risk factors include long-standing hypertension and connective tissue disorders, with symptoms such as sudden pain and potential complications like stroke. Management options include medical management for uncomplicated cases and endovascular therapy using stent grafts for treatment.

Uploaded by

Hafeez Lc
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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AORTIC DISSECTION

Presentation by:
Hafeez LC
CVT Intern
Definition:

 It is a syndrome that occurs when a tear in the


Intima results in the separation of the Intima from
the aortic wall resulting in the formation of a false
lumen
 Aortic dilatation >55mm is a definite risk factor of
for dissection
Mechanism of Aortic Dissection:
 Primary tear in the aortic Intima with blood from
the aortic lumen penetrating in to diseased
media and leading to dissection and creating
true and false lumen.
 Primary rupture of the Vasa vasorum leading to
haemorrhage in the Aortic wall, with intimal
disruption creating the intimal tear and aortic
dissection.
Classification
1.Stanford Classification:
 Type A - involves the Ascending aorta and can
propagate to the aortic arch & Descending aorta

 Type B - does not involves the Ascending aorta,


occurring any other part of Aortic arch
&Descending aorta
2. DeBakey Classification:

 Type l - originates in the Ascending aorta and


propagates at least to the Aortic arch

 Type ll - confined to Ascending aorta


 Type llI- originates distal to the subclavian artery
in the Descending aorta.
 llla - which extends distally to the diaphragm
 IIIb – which extends beyond the diaphragm
into the abdominal aorta
Risk factors:

→ Long standing arterial hypertension


→ Connective tissue disorder
→ Hereditary vascular disease
→ Iatrogenic factors.
→ Coarctation of aorta
Symptoms
 Sudden pain with maximum intensity
 Congestive heart failure
 Acute stroke
 Migratory pain
 Pain in neck , jaw or head – ascending
aortic involvement
 Pain in abdomen or lower extreme –
descending aortic involvement
Physical findings:

 Hypertension
 Hypotension (in proximal dissection with
aortic root involvement)
 Diastolic Murmur of AR
Chest X-ray findings:

 The dissected aorta may not be dilated


 Widening of aortic silhouette
 Pleural effusion
ECG

 Ecg can be normal


 ST-T changes
 Low voltage qrs complex
Echocardiography

TTE

 Visualize only a limited area of Ascending


aorta
 An intimal flap can be detected
 It can provide information such as Aortic
dilatation or aortic insufficiency
 Color flow imaging-identify the
communication between true and false lumen
TEE

 Major diagnostic tool for the detection of


Acute aortic dissection
 Complications such as pericardial effusion,
aortic insufficiency, pseudo-aneurysm, and
rupture can all be identified.
True False
Lumen Lumen
Size Large in aortic Small in aortic
root and root and
ascending ascending
aorta,small in aorta,large in
descending aorta descending aorta
Configuratio Round or oval Crescentric
n
Flap Concave Convex
curvature
Doppler Dense Sluggish
signal
Timing of Systole Out of phase
signal
Management

 Medical management:
 It is preferred for uncomplicated
descending aortic dissection
 The primary focus of medical management
is to reduce BP hence prevent extension
Endovascular Therapy

 It is a minimally invasive procedure


considered for the patient with aortic
dissection

 They uses a stent graft to treat a tear in


the wall of the aorta
Reference:

 FEIGANBAUMAS ECHOCARDIOGRAPHY
 COMPREHENSIVE TEXT BOOK OF
ECHOCARDIOGRAPHY
THANK YOU

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