PODCAST: Aortic Dissection (Deep Dive R6 MW)

פוסט זה זמין גם ב: עברית

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Aortic Dissection – when there is a tear in the intima layer of the aorta and the blood dissects the intima away from the media creating a false lumen in the aorta

1. Historical Features
   • Be VERY suspicious with ABRUPT onset of chest/back pain that reaches MAXIMAL SEVERITY immediately after onset of pain.
   • Chest pain or Back pain with a neurologic deficit
   • Pain “above and below the diaphragm”
2. Diagnosis
   • CT Angiography of chest abdomen and pelvis is gold standard
   • Can see widened mediastinum on CXR or dissection flap on POCUS
3. Treatment
   • Pain control first
   • Heart rate control second (goal <60bpm, use esmolol)
   • Blood pressure control third (goal 100-120SBP, use nicardipine/clevidipine)
   • CT Surgery consult (should go directly to OR with a Type A dissection)
   • Arterial Line placement

Further Reading:

Core EM – Aortic Dissection

LITFL – Aortic Dissection