Description:
Aabnormal dilatation of blood vessel
Pathogenesis:
Intimal tears progress to longitudinal intraluminal tears forming a lumen in the media.
There is collection of basophilic mucoid material in media and elastic tissue.
Most important factors promoting continued propagation of dissection are hypertension and velocity of left ventricular ejection.
Complications:
- Aortic rupture causing cardiac tamponade
- Leakage may cause pericarditis
- Dysphagia
Clinical Features:
- hypertension on initial presentation
- pericardial friction rub or AR murmur
- aortic insufficiency
- pulse deficit
- focal neurologic deficits may be present
Treatment:
1.Medical management for uncomplicated distal dissection
- sodium nitroprusside
- beta blockers
2.Surgery for acute proximal aortic dissection
- Operative repair to prevent rupture
- Emergency surgical repair for dissection of ascending aorta
- Cerebrospinal fluid drainage during and after surgery may reduce risk of neurological injury .