An aortic dissection is a tear in the inner layer of the aorta that leads to a progressively growing hematoma in the intima-media space.
Risk factors for aortic dissection include
- age and hypertension.
Patients typically present with
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sudden onset severe pain radiating into the chest, back, or abdomen.
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A widened mediastinum on chest x-ray is characteristic of the diagnosis.
The diagnosis is usually confirmed with
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CT angiogram in stable patients and transesophageal echocardiography (TEE) in unstable patients.
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The identification of a false lumen on imaging is highly suggestive of aortic dissection.
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CXR, and TTE (Transthoracic echocardiography) are not sensitive enough to reliably rule out aortic dissection
X-ray chest (PA view)
Widening of the mediastinum is accompanied by a prominent aortic knob on the left side and convexity in the region of the ascending aorta on the right side. Cardiac silhouette enlargement is also visible.
CT thorax (with contrast; axial view)
A mucosal flap can be seen dividing the lumen of the ascending and descending aorta. This radiological appearance confirms an aortic dissection.