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