cardiovascular disorders
Aortic Dissection
Symptoms and Signs of Aortic Dissection
Typically in aortic dissection, excruciating precordial or interscapular pain, often described as tearing or ripping, occurs abruptly ( Symptoms and signs reference ). The pain frequently migrates from the original location as the dissection extends along the aorta. Up to 20% of patients present with syncope due to severe pain, aortic baroreceptor activation, extracranial cerebral artery obstruction, or cardiac tamponade. Hypotension and tachycardia could indicate active bleeding. Occasionally, patients present with symptoms of malperfusion (ischemia due to the obstruction resulting from dissection), such as Symptoms and Signs , About 20% of patients have partial or complete deficits of major arterial pulses, which may wax and wane. Limb blood pressures may differ, sometimes by>30 mm Hg; this finding suggests a poor prognosis. A murmur of aortic regurgitation is heard in about 50% of patients with proximal dissection. Peripheral Symptoms and Signs may be present. Rarely, Leakage of blood or inflammatory serous fluid into the left pleural space may lead to signs of Pleural Effusion . Occlusion of a limb artery may cause signs of peripheral ischemia or neuropathy. Renal Artery Stenosis and Occlusion may cause oliguria or anuria. Only about 20% of patients with aortic dissection have pulse deficits. 1.Pape LA, Awais M, Woznicki EM, et al. Presentation, Diagnosis, and Outcomes of Acute Aortic Dissection: 17-Year Trends From the International Registry of Acute Aortic Dissection.J Am Coll Cardiol2015;66(4):350-358. doi:10.1016/j.jacc.2015.05.029 