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Internal Medicine

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Tips and Tricks in diagnosis and management of  aortic dissection 

1-With aortic dissection,There's unequal pulse volume and unequal BP on both sides

2-The pain is sudden severe from the start

3-The pain is usually Tearing in nature

4-The pain usually radiates to interscapular region

5-You can also hear AR murmur

6-You can also suspect aortic dissection if the patient is presenting with 2 concomitant acute events:

Stroke with MI

Acute limb ischemia with MI

7-Wide mediastinum in CXR

8-The investigation of the choice is CT aortography

9-Bedside Echocardiography can help in some cases to visualize the dissection flap especially in hemodynamically unstable patients

10-Standford classification will help to decide further management

Type A(dissection involving ascending aorta): urgent surgery

Type B(dissection not involving ascending aorta): Conservative (unless complicated) with serial imaging for follow up

Target SBP : 120

Target HR :60


Mazen Kherallah
S H
H S
A P
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