CardiovascularPending review

Aortic Dissection

A tear in the aortic intima lets high-pressure blood force its way into the vessel wall, splitting it along its length to create a false lumen that can obstruct branch arteries, rupture, or compromise the aortic valve, so the priority is same-hour imaging and blood pressure control, not analgesia alone.

In a nutshell

An intimal tear lets arterial pressure split the aortic wall into a true and false lumen. The Stanford classification predicts the danger: Type A threatens the valve, pericardium and coronary ostia and is a surgical emergency, while Type B is managed medically with blood pressure control unless it causes malperfusion.

Classic presentation

A patient with longstanding hypertension develops sudden, severe, tearing chest pain radiating to the back, with unequal blood pressures between the arms.

Key points

Pain is maximal at onset and can migrate as the dissection propagates, a different pattern from the crescendo pain of ischaemia.

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Educational content pending clinical review. Not medical advice.