Professional Documents
Culture Documents
• Risk factors
• hypertension
• due to damage to endothelial cell layer
predisposing to tear
• trauma
• coarctation of the aorta (narrowing of aorta)
increasing pressure*
• syphilis
• due to vasculitis and occlusion of vasa
vasorum (vessel of vessels)
• Ehlers-Danlos syndrome type 3
• Marfan's Syndrome (due to cystic medial
degeneration resulting from defect in fibrillin-1)
• pregnancy
• due to ↑ plasma volume
• copper deficiency
• due to weak collagen without copper-
dependent enzymatic cross-linking
Symptoms:
• classical presentation:
• acute onset of severe tearing anterior
chest pain radiating to the back aortic
Presentation
dissection*
• asymmetric upper extremity blood
pressures – when measured BP
difference within 10-20*
• due to compression of subclavian
artery unilaterally
•in severe cases:
• syncope
• decreased pulse
• shock
• Where rupture? rupture into pericardial
sac***, pleural cavity, or peritoneal
cavity hence no space for heart to
contract***
• cardiac tamponade*** (completely
filled with blood) is the most
common cause of death****
Physical Exam:
• asymmetric upper extremity pulses
• diastolic murmur secondary to aortic
regurgitation (dilation of the aorta stretches
the aortic ring with widening of the aortic root)
Evaluation
ACS
Predisposition to atherosclerosis and MI