Aortic dissection - emergency summary for the ED Topic: Cardiology Section path: Cardiovascular Emergencies & Critical Conditions
Acute Coronary Syndromes (ACS) & Myocardial Infarction (MI)
Aortic Dissection
Pathophysiology and clinical importance
An aortic dissection occurs when an intimal tear allows blood to enter the aortic media and create a false lumen. Extension can be rapid and life‑threatening, with complications including acute aortic regurgitation, pericardial tamponade, myocardial ischaemia from coronary ostial involvement, branch‑vessel malperfusion and frank rupture.
Timely recognition, appropriate haemodynamic control and urgent specialist referral are critical.
Key predisposing factors
- Longstanding hypertension (most common risk factor).
- Bicuspid aortic valve.
- Known aortic aneurysm.
- Prior aortic surgery.
- Connective‑tissue disorders (Marfan syndrome, Loeys‑Dietz syndrome).
- Pregnancy.
- Stimulant drug use (cocaine, amphetamines).
- Blunt chest trauma.
- Older age.
- Inherited conditions tend to present at a younger age.