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{{CMG}}; '''Associate Editor-In-Chief:'''  {{CZ}}{{Sahar}}
{{CMG}}; '''Associate Editor-In-Chief:'''  {{CZ}}{{Sahar}}
==Overview==
==Overview==
The symptoms of aortic dissection usually develop in the fifth decade of life and start with symptoms such as sudden onset chest/back pain. If left untreated, patients with aortic dissection may progress to develop Aortic regurgitation, myocardial ischemia, and cardiac tamponade. The complications of aortic dissection include but not limited to aortic rupture, pericardial tamponade, myocardial ischemia, compression of nearby organs and etc. Aortic dissection carries a poor prognosis. Mortality rate differs based on the type of dissection and is higher in type A compared to type B (25% versus 12%).
The [[symptoms]] of aortic dissection usually develop in the fifth decade of life and start with [[symptoms]] such as sudden onset [[Chest pain|chest]]/[[back pain]]. If left untreated, [[patients]] with aortic dissection may progress to develop [[aortic regurgitation]], [[myocardial ischemia]], and [[cardiac tamponade]]. The [[complications]] of aortic dissection include but not limited to [[aortic rupture]], [[pericardial tamponade]], [[myocardial ischemia]], compression of nearby organs and etc. Aortic dissection carries a poor [[prognosis]]. [[Mortality rate]] differs based on the type of dissection and is higher in type A compared to type B (25% versus 12%).
== Natural History ==
== Natural History, Complications, and Prognosis ==
*The symptoms of aortic dissection usually develop in the fifth decade of life and start with symptoms such as sudden onset chest/back pain.
 
*If left untreated, patients with aortic dissection may progress to develop Aortic regurgitation, myocardial ischemia, and cardiac tamponade.
=== Natural History ===
==Complications==
 
*The [[symptoms]] of aortic dissection usually develop in the fifth decade of life and start with [[symptoms]] such as sudden onset [[Chest pain|chest]]/[[back pain]].<ref name="JuangBraverman2008">{{cite journal|last1=Juang|first1=Derek|last2=Braverman|first2=Alan C.|last3=Eagle|first3=Kim|title=Aortic Dissection|journal=Circulation|volume=118|issue=14|year=2008|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.108.799908}}</ref>
*If left untreated, [[patients]] with aortic dissection may progress to develop [[aortic regurgitation]], [[myocardial ischemia]], and [[cardiac tamponade]].
 
===Complications===
The complications of aortic dissection include:<ref name="CambriaBrewster1988">{{cite journal|last1=Cambria|first1=Richard P.|last2=Brewster|first2=David C.|last3=Gertler|first3=Jonathan|last4=Moncure|first4=Ashby C.|last5=Gusberg|first5=Richard|last6=Tilson|first6=M.David|last7=Darling|first7=R.Clement|last8=Hammond|first8=Grahme|last9=Megerman|first9=Joseph|last10=Abbott|first10=William M.|title=Vascular complications associated with spontaneous aortic dissection|journal=Journal of Vascular Surgery|volume=7|issue=2|year=1988|pages=199–209|issn=07415214|doi=10.1016/0741-5214(88)90137-1}}</ref><ref name="FadahunsiRomeo2014">{{cite journal|last1=Fadahunsi|first1=Opeyemi|last2=Romeo|first2=Michael|title=Cardiac tamponade – presentation of type A aortic dissection|journal=Journal of Community Hospital Internal Medicine Perspectives|volume=4|issue=5|year=2014|pages=25449|issn=2000-9666|doi=10.3402/jchimp.v4.25449}}</ref><ref name="CaiCao2012">{{cite journal|last1=Cai|first1=Jingjing|last2=Cao|first2=Yu|last3=Yuan|first3=Hong|last4=Yang|first4=Kan|last5=Zhu|first5=Yuan-Shan|title=Inferior myocardial infarction secondary to aortic dissection associated with bicuspid aortic valve|journal=Journal of Cardiovascular Disease Research|volume=3|issue=2|year=2012|pages=138–142|issn=09753583|doi=10.4103/0975-3583.95370}}</ref><ref name="SiegelmanSprayregen1970">{{cite journal|last1=Siegelman|first1=Stanley S.|last2=Sprayregen|first2=Seymour|last3=Strasberg|first3=Zeno|last4=Attai|first4=Lari A.|last5=Robinson|first5=George|title=Aortic Dissection and the Left Renal Artery|journal=Radiology|volume=95|issue=1|year=1970|pages=73–78|issn=0033-8419|doi=10.1148/95.1.73}}</ref><ref name="BlancoDíez-Tejedor1999">{{cite journal|last1=Blanco|first1=M.|last2=Díez-Tejedor|first2=E.|last3=Larrea|first3=J. L.|last4=Ramírez|first4=U.|title=Neurologic complications of type I aortic dissection|journal=Acta Neurologica Scandinavica|volume=99|issue=4|year=1999|pages=232–235|issn=00016314|doi=10.1111/j.1600-0404.1999.tb07352.x}}</ref><ref name="ArataImagama2015">{{cite journal|last1=Arata|first1=Kenichi|last2=Imagama|first2=Itsumi|last3=Shigehisa|first3=Yoshiya|last4=Mukaihara|first4=Kousuke|last5=Toyokawa|first5=Kenji|last6=Matsuba|first6=Tomoyuki|last7=Imoto|first7=Yutaka|title=Aortic Fenestration for Type B Chronic Aortic Dissection Complicated with Lower Limb Malperfusion Induced by Walking Exercise|journal=Annals of Vascular Diseases|volume=8|issue=1|year=2015|pages=29–32|issn=1881-641X|doi=10.3400/avd.cr.14-00101}}</ref>
The complications of aortic dissection include:<ref name="CambriaBrewster1988">{{cite journal|last1=Cambria|first1=Richard P.|last2=Brewster|first2=David C.|last3=Gertler|first3=Jonathan|last4=Moncure|first4=Ashby C.|last5=Gusberg|first5=Richard|last6=Tilson|first6=M.David|last7=Darling|first7=R.Clement|last8=Hammond|first8=Grahme|last9=Megerman|first9=Joseph|last10=Abbott|first10=William M.|title=Vascular complications associated with spontaneous aortic dissection|journal=Journal of Vascular Surgery|volume=7|issue=2|year=1988|pages=199–209|issn=07415214|doi=10.1016/0741-5214(88)90137-1}}</ref><ref name="FadahunsiRomeo2014">{{cite journal|last1=Fadahunsi|first1=Opeyemi|last2=Romeo|first2=Michael|title=Cardiac tamponade – presentation of type A aortic dissection|journal=Journal of Community Hospital Internal Medicine Perspectives|volume=4|issue=5|year=2014|pages=25449|issn=2000-9666|doi=10.3402/jchimp.v4.25449}}</ref><ref name="CaiCao2012">{{cite journal|last1=Cai|first1=Jingjing|last2=Cao|first2=Yu|last3=Yuan|first3=Hong|last4=Yang|first4=Kan|last5=Zhu|first5=Yuan-Shan|title=Inferior myocardial infarction secondary to aortic dissection associated with bicuspid aortic valve|journal=Journal of Cardiovascular Disease Research|volume=3|issue=2|year=2012|pages=138–142|issn=09753583|doi=10.4103/0975-3583.95370}}</ref><ref name="SiegelmanSprayregen1970">{{cite journal|last1=Siegelman|first1=Stanley S.|last2=Sprayregen|first2=Seymour|last3=Strasberg|first3=Zeno|last4=Attai|first4=Lari A.|last5=Robinson|first5=George|title=Aortic Dissection and the Left Renal Artery|journal=Radiology|volume=95|issue=1|year=1970|pages=73–78|issn=0033-8419|doi=10.1148/95.1.73}}</ref><ref name="BlancoDíez-Tejedor1999">{{cite journal|last1=Blanco|first1=M.|last2=Díez-Tejedor|first2=E.|last3=Larrea|first3=J. L.|last4=Ramírez|first4=U.|title=Neurologic complications of type I aortic dissection|journal=Acta Neurologica Scandinavica|volume=99|issue=4|year=1999|pages=232–235|issn=00016314|doi=10.1111/j.1600-0404.1999.tb07352.x}}</ref><ref name="ArataImagama2015">{{cite journal|last1=Arata|first1=Kenichi|last2=Imagama|first2=Itsumi|last3=Shigehisa|first3=Yoshiya|last4=Mukaihara|first4=Kousuke|last5=Toyokawa|first5=Kenji|last6=Matsuba|first6=Tomoyuki|last7=Imoto|first7=Yutaka|title=Aortic Fenestration for Type B Chronic Aortic Dissection Complicated with Lower Limb Malperfusion Induced by Walking Exercise|journal=Annals of Vascular Diseases|volume=8|issue=1|year=2015|pages=29–32|issn=1881-641X|doi=10.3400/avd.cr.14-00101}}</ref>
=== Cardiovascualr Complications===
==== Cardiovascualr Complications====
 
*[[Aortic rupture]]
*[[Aortic rupture]]
*[[Pericardial tamponade]]
*[[Pericardial tamponade]]
*[[Acute aortic regurgitation]]  
*[[Acute aortic regurgitation]]  
*[[Myocardial ischemia]]
*[[Myocardial ischemia]]
*Thoracic aortic aneurysm
*[[Thoracic aortic aneurysm]]
*[[Renal ischemia]]
*[[Renal ischemia]]
*[[Superior mesenteric artery]] dissection and resultant visceral ischemia
*[[Superior mesenteric artery]] dissection and resultant [[visceral]] [[ischemia]]
*Pleural effusion
*[[Pleural effusion]]
*[[Claudication]] due to an extension of the dissection into the [[iliac arteries]]
*[[Claudication]] due to an extension of the dissection into the [[iliac arteries]]
===Neurologic Complications===
 
======Neurologic Complications======
 
*[[Ischemic]] [[cerebrovascular accident]] ([[CVA]]) due to dissection into the head [[vessel]]s
*[[Ischemic]] [[cerebrovascular accident]] ([[CVA]]) due to dissection into the head [[vessel]]s
*[[Hemiplegia]] due to dissection into the [[spinal cord|spinal]] [[artery|arteries]]
*[[Hemiplegia]] due to dissection into the [[spinal cord|spinal]] [[artery|arteries]]
*[[anesthesia|Hemianesthesia]] due to dissection into the [[spinal cord|spinal]] [[artery|arteries]]
*[[anesthesia|Hemianesthesia]] due to dissection into the [[spinal cord|spinal]] [[artery|arteries]]
=== Compression of Nearby Organs===
 
===== Compression of Nearby Organs=====
 
*[[Superior vena cava syndrome]] due to compression of the [[superior vena cava]]
*[[Superior vena cava syndrome]] due to compression of the [[superior vena cava]]
*[[Horner syndrome]] (compression of the [[superior cervical ganglia]])
*[[Horner syndrome]] (compression of the [[superior cervical ganglia]])
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*[[Hemoptysis]] (compression of and erosion into the [[bronchus]])
*[[Hemoptysis]] (compression of and erosion into the [[bronchus]])
*[[Vocal cord paralysis]] and [[hoarseness]] (compression of the [[recurrent laryngeal nerve]])
*[[Vocal cord paralysis]] and [[hoarseness]] (compression of the [[recurrent laryngeal nerve]])
==Prognosis==
 
*Aortic dissection carries a poor prognosis.<ref>{{cite journal|title=Correspondence|journal=The Annals of Thoracic Surgery|volume=67|issue=2|year=1999|pages=593|issn=00034975|doi=10.1016/S0003-4975(99)00037-5}}</ref>
===Prognosis===
*Mortality rate differs based on the type of dissection and is higher in type A compared to type B (25% versus 12%).
 
*Aortic dissection carries a poor [[prognosis]].<ref>{{cite journal|title=Correspondence|journal=The Annals of Thoracic Surgery|volume=67|issue=2|year=1999|pages=593|issn=00034975|doi=10.1016/S0003-4975(99)00037-5}}</ref>
*[[Mortality rate]] differs based on the type of dissection and is higher in type A compared to type B (25% versus 12%).


== References ==
== References ==

Latest revision as of 15:54, 24 December 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Sahar Memar Montazerin, M.D.[3]

Overview

The symptoms of aortic dissection usually develop in the fifth decade of life and start with symptoms such as sudden onset chest/back pain. If left untreated, patients with aortic dissection may progress to develop aortic regurgitation, myocardial ischemia, and cardiac tamponade. The complications of aortic dissection include but not limited to aortic rupture, pericardial tamponade, myocardial ischemia, compression of nearby organs and etc. Aortic dissection carries a poor prognosis. Mortality rate differs based on the type of dissection and is higher in type A compared to type B (25% versus 12%).

Natural History, Complications, and Prognosis

Natural History

Complications

The complications of aortic dissection include:[2][3][4][5][6][7]

Cardiovascualr Complications

Neurologic Complications
Compression of Nearby Organs

Prognosis

  • Aortic dissection carries a poor prognosis.[8]
  • Mortality rate differs based on the type of dissection and is higher in type A compared to type B (25% versus 12%).

References

  1. ↑ Juang, Derek; Braverman, Alan C.; Eagle, Kim (2008). "Aortic Dissection". Circulation. 118 (14). doi:10.1161/CIRCULATIONAHA.108.799908. ISSN 0009-7322.
  2. ↑ Cambria, Richard P.; Brewster, David C.; Gertler, Jonathan; Moncure, Ashby C.; Gusberg, Richard; Tilson, M.David; Darling, R.Clement; Hammond, Grahme; Megerman, Joseph; Abbott, William M. (1988). "Vascular complications associated with spontaneous aortic dissection". Journal of Vascular Surgery. 7 (2): 199–209. doi:10.1016/0741-5214(88)90137-1. ISSN 0741-5214.
  3. ↑ Fadahunsi, Opeyemi; Romeo, Michael (2014). "Cardiac tamponade – presentation of type A aortic dissection". Journal of Community Hospital Internal Medicine Perspectives. 4 (5): 25449. doi:10.3402/jchimp.v4.25449. ISSN 2000-9666.
  4. ↑ Cai, Jingjing; Cao, Yu; Yuan, Hong; Yang, Kan; Zhu, Yuan-Shan (2012). "Inferior myocardial infarction secondary to aortic dissection associated with bicuspid aortic valve". Journal of Cardiovascular Disease Research. 3 (2): 138–142. doi:10.4103/0975-3583.95370. ISSN 0975-3583.
  5. ↑ Siegelman, Stanley S.; Sprayregen, Seymour; Strasberg, Zeno; Attai, Lari A.; Robinson, George (1970). "Aortic Dissection and the Left Renal Artery". Radiology. 95 (1): 73–78. doi:10.1148/95.1.73. ISSN 0033-8419.
  6. ↑ Blanco, M.; Díez-Tejedor, E.; Larrea, J. L.; Ramírez, U. (1999). "Neurologic complications of type I aortic dissection". Acta Neurologica Scandinavica. 99 (4): 232–235. doi:10.1111/j.1600-0404.1999.tb07352.x. ISSN 0001-6314.
  7. ↑ Arata, Kenichi; Imagama, Itsumi; Shigehisa, Yoshiya; Mukaihara, Kousuke; Toyokawa, Kenji; Matsuba, Tomoyuki; Imoto, Yutaka (2015). "Aortic Fenestration for Type B Chronic Aortic Dissection Complicated with Lower Limb Malperfusion Induced by Walking Exercise". Annals of Vascular Diseases. 8 (1): 29–32. doi:10.3400/avd.cr.14-00101. ISSN 1881-641X.
  8. ↑ "Correspondence". The Annals of Thoracic Surgery. 67 (2): 593. 1999. doi:10.1016/S0003-4975(99)00037-5. ISSN 0003-4975.

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