RT Book, Section
A1 Cotarlan, Vlad
A1 Panza, Antonio
A2 Schmidt, Gregory A.
A2 Kress, John P.
A2 Douglas, Ivor S.
SR Print(0)
ID 1201802193
T1 Aortic Dissection 
T2 Hall, Schmidt and Wood’s Principles of Critical Care, 5<sup>th</sup> Edition
YR 2023
FD 2023
PB McGraw Hill
PP New York, NY
SN 9781264264353
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1201802193
RD 2024/09/11
AB KEY  POINTSTimely  diagnosis  of  aortic  dissection  has  more  life-saving  potential  than  almost  any  other  diagnosis  in  medicine.Diagnosis  can  be  difficult,  requiring  high  clinical  suspicion  and  quick,  efficient  use  of  diagnostic  modalities.Clinical  clues  are  the  typical  pain,  incongruous  poor  tissue  perfusion  despite  hypertension,  or  evidence  of  aortic  branch  occlusion.Emergent  control  or  support  of  blood  pressure  and  pain  is  imperative.Urgent  CT  angiogram  or  transesophageal  echocardiography  are  preferred  means  to  confirm  the  diagnosis  and  detect  complications.Distinguishing  type  A  (ascending  aorta  involved)  versus  type  B  (only  descending  aorta  involved)  guides  definitive  treatment.Type  A  dissection  requires  emergency  cardiac  surgical  repair.Uncomplicated  type  B  dissection  is  managed  medically.Complicated  type  B  dissection  is  usually  managed  with  endostenting:  surgery  is  rarely  performed.Long-term  surveillance  and  strict  control  of  hypertension  are  important  to  identify  the  need  for  late  intervention  and  maximize  long-term  survival.