What is aortic dissection?

What is aortic dissection?

• A. Blockage of a coronary artery causing ischemia
• B. Injury to inner-most layer of the aorta allowing blood to flow between layers, causing a tearing effect
• C. A tear in the intima leading to valve regurgitation
• D. Dilation of the aorta due to atherosclerosis

Answer: (B)

Aortic dissection occurs when a tear develops in the inner lining (intima) of the aorta, allowing blood to enter and split the wall layers (the media). This creates a false lumen that can propagate along the vessel, separating the layers and compromising blood flow to branch vessels or causing rupture. The hallmark is a sudden, severe ripping or tearing chest or back pain, often with unequal blood pressures in the arms. Management centers on limiting further tearing by reducing shear stress: give IV beta-blockers to lower heart rate and blood pressure, then add vasodilators if needed to reach a target systolic around 100–120 mmHg. Avoid anticoagulants and thrombolytics since they can worsen bleeding. If the dissection involves the ascending aorta, surgical repair is usually required; distal dissections may be treated medically or with endovascular approaches. Watch for complications like new aortic regurgitation, myocardial ischemia, tamponade, or organ hypoperfusion. Blockage of a coronary artery describes a heart attack, not dissection; a tear causing valve regurgitation is related but doesn't define the process; dilation from atherosclerosis describes an aneurysm, not dissection.

Aortic dissection occurs when a tear develops in the inner lining (intima) of the aorta, allowing blood to enter and split the wall layers (the media). This creates a false lumen that can propagate along the vessel, separating the layers and compromising blood flow to branch vessels or causing rupture. The hallmark is a sudden, severe ripping or tearing chest or back pain, often with unequal blood pressures in the arms. Management centers on limiting further tearing by reducing shear stress: give IV beta-blockers to lower heart rate and blood pressure, then add vasodilators if needed to reach a target systolic around 100–120 mmHg. Avoid anticoagulants and thrombolytics since they can worsen bleeding. If the dissection involves the ascending aorta, surgical repair is usually required; distal dissections may be treated medically or with endovascular approaches. Watch for complications like new aortic regurgitation, myocardial ischemia, tamponade, or organ hypoperfusion. Blockage of a coronary artery describes a heart attack, not dissection; a tear causing valve regurgitation is related but doesn't define the process; dilation from atherosclerosis describes an aneurysm, not dissection.