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Review

Diagnosis and clinical management of aortic dissection

, &
Pages 123-132 | Published online: 19 Jun 2014
 

Abstract:

Aortic dissection is a potentially lethal clinical entity that requires rapid diagnosis, appropriate medical management, and potential surgical intervention. Nomenclature and treatments for aortic dissection are based on the location and extent of the dissection. Aortic dissections result from an intimal tear and may occur in the ascending aorta, aortic arch, or descending aorta. Patients with aortic dissection may present with a wide variety of symptoms secondary to the pattern of dissection and end organ malperfusion. Optimal medical therapy, often using a combination of medications to achieve systolic blood pressure control is essential in management of dissection. Surgical intervention is indicated for aortic dissection of the ascending aorta and aortic arch, and in selective dissections of the descending aorta. Regardless of operative technique, the goal of surgery is to prevent progression of the dissection, restore end organ perfusion whenever possible, and prevent rapid cardiovascular collapse and death.