EC Emergency Medicine And Critical Care

Aortic dissection is the most frequent and most dreaded aortic emergency, including intra-mural hematoma and penetrating aortic ulcer. An acute dissection is one in which the individual presents within the first two weeks. The diagnosis is suspected based on symptoms with a sudden onset of severe chest or back pain. Medical imaging such as CT scan, MRI, or ultrasound used to confirm and further evaluate the dissection, for the selection of patients to be operated on, for the preparation of the operation and for post-treatment follow-up. Two main types are Stanford type A, which involves the first part of the aorta, and type B, which does not. Organ mal perfusion is the most frequent acute complication, confirmed by imaging and/or biology as the first case we deal with. Aneurysmal dilatation of the false channel is the most frequent chronic complication.

Prevention is by blood pressure control and smoking cessation and for type A dissections, urgent surgical treatment is indicated. For uncomplicated type B dissections, medical treatment gives better results.

 Keywords: Multidetector-Computed-Tomography (CT); Magnetic Resonance Imaging (MRI); Thoracic Aorta; Type A and B Dissection; Endovascular/Surgical Procedures

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