Principles of Critical Care > Part III. Cardiovascular Disorders > Chapter 30. Aortic Dissection Joseph J. Austin

Key Points

"Aortic dissection is the most common catastrophe affecting the aorta, occurring two to three times more commonly than acute abdominal aortic aneurysm rupture.¹ The reported incidence is approximately 10 to 20 per 1 million per year.² Rarely is the outcome of a cardiovascular disease so dependent on the skills and cooperation of the emergency room physician, the cardiac surgeon, and the intensivist as it is with acute dissections of the aorta. Maximal survival depends on a high index of suspicion of the diagnosis despite a myriad of different presentations, early pharmacologic intervention for control of hypertension, rapid diagnosis with definitive imaging, and then appropriate relegation to medical or surgical management depending on the dissection type. Without treatment, the 3-month mortality is 85% to 90%, but with the appropriate treatment, survival rates of over 80% can be expected...."