Aortic Dissection - Diagnosis and Management Summary
• HPI: sudden onset, "tearing" chest pain, radiation to back, may have concurrent stroke-like symptoms
• Risk Factors: Male, yo, HTN, cocaine, tobacco use, connective tissue disorder syphilis, FHx
• Imaging: CTA Dissection protocol
• Classification:
- Type A (includes ascending aorta)
- Type B (distal to subclavian artery)
Management:
• Type A = emergent surgical intervention
• Type B = medical management
- Goal HR < 60 bpm (esmolol, metoprolol, labetalol)
- goal SBP 90-100 (nitroprusside, nicardipine)
- reversal of anticoagulation
- MH/CCF/CWRU EM Res @MetroHealth_EM
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