Aortic dissection natural history, complications and prognosis: Difference between revisions

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(New page: {{Template:Aortic dissection}} {{CMG}} '''Associate Editor-In-Chief:''' {{CZ}} == Natural History == If the patient remains untreated, the mortality is: * 1% per hour during the first ...)
 
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'''Associate Editor-In-Chief:''' {{CZ}}
'''Associate Editor-In-Chief:''' {{CZ}}


== Natural History ==
== Natural History ==
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* 75% at 2 weeks
* 75% at 2 weeks
* 90% at 1 year
* 90% at 1 year
==Complications==
The complications of aortic dissection include:
*[[Hypotension]] and [[shock]] from a possible aortic rupture
*[[Pericardial tamponade]]
*[[Acute aortic regurgitation]]due to the aortic dissection generating into [[Valsalva]] with an aortic valve insufficiency
*[[Pulmonary edema]]
*[[Myocardial ischemia]] due to involvement from the right or left coronary ostium
*[[Mesenteric]] and [[renal ischemia]]- can lead to [[hematuria]], [[renal infarction]], [[acute renal failure]], or visceral ischemia
*[[Claudication]] due to an extension of the dissection into the iliac arteries
*Redissection and aortic diameter enlargement
*Aneurysmal dilatation and [[saccular aneurysm]]
Neurologic findings include:
*Ischemic cerebrovascular accident ([[CVA]])
*[[Hemiplegia]]
*Hemianesthesia
Compressive symptoms include:
*[[Superior vena cava syndrome]]
*[[Horner syndrome]] (involves superior cervical ganglia)
*[[Dysphagia]] (involves the esophagus)
*Airway compromise
*[[Hemoptysis]] (involves the compression of the bronchus)
*[[Vocal cord paralysis]] and hoarseness
==Prognosis==
*30% hospital-based mortality rates
*60% 10-year survival rate when treated
The mortality rate is conditional and based upon the patient's clinical condition.
Type A aortic dissection
:*surgical treatment-30% mortality rate
:*medial treatment-60% mortality rate
Type B aortic dissection
:*surgical treatment-10% mortality rate
:*medical treatment- 30% mortality rate


== References ==
== References ==

Revision as of 14:29, 13 July 2011

Aortic dissection Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Aortic dissection from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Special Scenarios

Management during Pregnancy

Case Studies

Case #1


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Natural History

If the patient remains untreated, the mortality is:

  • 1% per hour during the first day
  • 75% at 2 weeks
  • 90% at 1 year

Complications

The complications of aortic dissection include:

Neurologic findings include:

  • Ischemic cerebrovascular accident (CVA)
  • Hemiplegia
  • Hemianesthesia

Compressive symptoms include:


Prognosis

  • 30% hospital-based mortality rates
  • 60% 10-year survival rate when treated

The mortality rate is conditional and based upon the patient's clinical condition.

Type A aortic dissection

  • surgical treatment-30% mortality rate
  • medial treatment-60% mortality rate

Type B aortic dissection

  • surgical treatment-10% mortality rate
  • medical treatment- 30% mortality rate

References

Acknowledgements

The content on this page was first contributed by: David Feller-Kopman, MD and C. Michael Gibson M.S., M.D.

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