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Aortic dissection generally presents as a hypertensive emergency, and the prime consideration of medical management is to decrease the shear stress in the aortic wall (dP/dt (force of ejection of blood from the left ventricle)) by decreasing blood pressure and the heart rate.
First, upstream issues: blood flow increases into the aortic branches, and therefore blood pressure increases in the upper extremities and the head. Increased cerebral blood flow means an increased risk of berry aneurysms, where weak spots along blood vessels in the brain balloon out from the high pressures and become tiny sacs filled with blood.
Arterial dissections become life-threatening when growth of the false lumen prevents perfusion of the true lumen and the related end organs. For example, in an aortic dissection, if the left subclavian artery orifice were distal to the origin of the dissection, then the left subclavian would be said to be perfused by the false lumen, while the left common carotid (and its end organ, the left ...
People who are experiencing aortic dissection, meanwhile—a tear in one of the body’s major arteries—describe sudden, stabbing pain in the middle of the chest that radiates to their back.
Aortography involves placement of a catheter in the aorta and injection of contrast material while taking X-rays of the aorta.The procedure is known as an aortogram. The diagnosis of aortic dissection can be made by visualization of the intimal flap and flow of contrast material in both the true lumen and the false lumen.
The severity of coarctation of the aorta can be rated by a combination of the smallest aortic cross-sectional area of the aorta (adjusted for body surface area) as measured by 3D-rendered contrast MRI, as well as mean heart rate–corrected flow deceleration in the descending aorta as measured by phase contrast magnetic resonance imaging.
As the blood moves into the aortic arch, the area with the highest velocity tends to be on the inner wall. Helical flow within the ascending aorta and aortic arch help to reduce flow stagnation and increase oxygen transport. [4] As the blood moves into the descending aorta, rotations in the flow are less present.
The most common risk factor for type B aortic dissection is hypertension. The first line treatment for type B aortic dissection is aimed at reducing both heart rate and blood pressure and is referred to as anti-impulse therapy. A thoracic aortic stent graft, seen on chest X-ray which was placed during a TEVAR procedure.
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