Etiology
Chronic hypertension most commonly causes dissection by increasing stress on which specific aortic layer?
Tunica intima
Propagation of the dissection is driven primarily by what hemodynamic force?
Shear stress
A patient presents with chest pain radiating to the back and unequal arm BPs. What single diagnosis must be ruled out before anticoagulation?
Aortic dissection
Why is D-dimer elevated in aortic dissection?
Clotting in turbulent environment of false lumen
Compression of renal arteries leads to what lab abnormality?
Elevated creatinine
Mutation in this protein leads to structural instability of elastic fibers in the aorta
Fibrillin-1
Compression of the true lumen leads to what downstream physiologic consequence?
Decreased perfusion / organ ischemia
Neurologic deficits in dissection most often result from involvement of which arterial system?
Carotid arteries
Why must beta blockers be given before vasodilators in dissection?
prevent reflex tachycardia
Hyperkalemia in this setting is primarily due to release of what intracellular component?
Potassium from muscle cells
Which hormones impact vessel integrity during pregnancy?
Estrogen (collagen and elastin remodeling) and progesterone (vasodilation)
The false lumen forms between which two layers of the aortic wall?
Intima and media
A new diastolic murmur in dissection suggests involvement of which valve?
Aortic valve (aortic regurgitation)
In an unstable patient, which diagnostic modality is preferred?
TEE
Why do severe cases of hyperkalemia lead to widened QRS complexes?
Inactivation of sodium channels slows conduction
Rapid injuries most commonly cause dissection at this anatomical location
Aortic isthmus
In vasculitis, inflammatory damage leads to destruction of this layer of the vessel wall, predisposing to dissection.
Why can aortic dissection mimic myocardial infarction clinically?
ischemia from coronary involvement
Why is Type B dissection typically managed medically rather than surgically?
Why is Type B dissection typically managed medically rather than surgically?
Hyperkalemia raises the resting membrane potential
true
A 65-year-old man presents with sudden, severe chest pain radiating to his back. Imaging confirms an aortic dissection. Which of the following is the most common underlying cause?
Chronic hypertension
This shared mechanism explains why both bicuspid aortic valve and vasculitis increase risk of aortic dissection.
What is weakening of the aortic wall (medial degeneration / structural damage)?
A patient with aortic dissection suddenly becomes hypotensive with JVD and muffled heart sounds. This occurs because blood accumulates in this space, increasing pressure around the heart.
What is the pericardial space?
A patient with chest pain has a systolic blood pressure of 160 mmHg in the right arm and 110 mmHg in the left. This finding suggests involvement of this arterial branch.
What is the subclavian artery?
Which type of dissection is responsible for cardiac tamponade
type A