Aortic Dissection: Teaching Points
Case Details:48 yrs old lady with tearing pain chest on CT angiography shows large, dissection of the entire aorta , including Ascending aorta , with celiac, SMA, renal arising from true lumen (cerebral vessels showing no dissection) with cobweb sign and beak signs positive.Teaching points by Dr MGK Murthy, Dr Pritam, CT Technologist: Mr Shekhar1. Aortic dissection occurs when the blood enters medial layer through a penetrating ulcer or tear of intima 2. Two types: Acute, when clinical symptoms14 days More useful , Stanford A: involvement of ascending aorta& or arch, possibly descending as well (requires surgery) Stanford B: Descending aorta and / arch distal to left subclavian and beyond (medial management unless complications ) Debakey's I- ascending aorta/ arch and possibly beyondDebakey's II- only ascending aorta Debkey's III-- descending aorta 3. If it involves coronaries , it may produce tamponade and death withBecks Traid positive (a) low blood pressure or narrow pulse pressure, (b) muffled heart sounds and (c) raised JVP4. Usually presents with tearing pain chest or end organ schema . CT angiography helpful (disadv = does not detect site of intimal tear) Signs-Dilated aorta, double lumen, Intimal flap , intramural hematoma, Mercedes-Benz sign(three distinct intimal flaps that have a ...
Source: Sumer's Radiology Site - Category: Radiology Authors: Sumer Sethi Source Type: blogs
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