AORTIC DISSECTION EMERGENCY

An aortic dissection is a life-threatening medical emergency occurring when the inner layer of the aorta tears, causing blood to flow between layers and potentially rupture. It requires immediate, often surgical, intervention, as mortality increases by 1–2% per hour if untreated. Call 911 immediately for sudden, severe "tearing" or "ripping" chest, back, or abdominal pain.

Key Emergency Symptoms

Sudden, severe pain: Often described as ripping, tearing, or stabbing, typically in the chest, upper back, or abdomen.

Neurological deficits: Stroke-like symptoms, dizziness, confusion, or weakness.

Pulse discrepancies: A significant difference in blood pressure or pulse between the right and left arm.

Shortness of breath or fainting.

Atypical presentation: Painless dissection can occur, sometimes presenting only with shock or neurological issues.

Immediate Emergency Actions

Call 911: Do not drive to the hospital.

Emergency Medicine: Doctors will immediately focus on reducing blood pressure and heart rate (target systolic BP <120 mm Hg) using IV medications to prevent further damage.

Diagnosis: Rapid diagnosis is made via CTA (CT Angiography).

Surgery: Type A (ascending aorta) requires immediate emergency surgery. Type B (descending aorta) may be managed with medication initially, or urgent surgery if complications exist.

Risk Factors

Chronic high blood pressure (hypertension) is the most common cause.

Connective tissue diseases (e.g., Marfan syndrome).

Previous heart surgery or known aneurysm.

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