Aortic dissection (type A)
The incidence rate is 2/3.5 cases per 100.000 persons every year, with the 75% of cases diagnosed between 40 and 70 years of age.
The prognosis is severe due to the high risk of acute and premature complications occurring in the proximal aorta. The vast majority of deaths is related to rupture, generally in the site of the initial laceration, infarction, due to coronary flow obstruction, or aortic valve insufficiency, related to exhaustion of the aortic valvular annulus or cusps.
The major risk factors for aortic dissection are degeneration of the vascular wall and hypertension. It is commonly associated with genetic disorders that affect the connective tissue, such as Marfan syndrome, Turner syndrome, Ehlers-Danlos syndrome. Pregnancy, aortic aneurysm, atherosclerosis and previous surgical interventions on the aorta represent additional risk factors for the development of the disease.
Individuals with type A aortic dissection typically experience a sudden onset of severe chest pain, hypotension, hypovolemic shock, cardiac insufficiency related to tamponade, infarction or valvular insufficiency.
CT scan, especially with arterial contrast enhancement (CTA), is the gold-standard for the diagnosis of aortic dissection.
Type A dissections are medical emergencies and require surgery.
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Aortic valve
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Pulmonary valve
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Aorta
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True lumen
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False lumen
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Pulmonary artery
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Left atrium
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Right atrium
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Myocardium
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Apex
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Mitral valve
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Tricuspid valve
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Right heart
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Left heart
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Heart
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