Aortic dissection

• Facts:
  Tear in the wall of the aorta
  Different classifications (Stanford and DeBakey)
• History / PE:
  Tearing, retrosternal pain that radiates to the back
  
• Diagnosis:
  Transesophageal echocardiography (TEE)
• Treatment:
  Stanford type A
  Surgery and medical therapy (β blocker)
  
  Stanford type B
  Medical therapy alone (β blocker)
• Complications:
  Cardiac tamponade
  Acute aortic regurgitation
  Stroke
  Renal failure
• Notes:
  Stanford type A (ascending aorta), type B (descending aorta)
  
  DeBakey I (starts in ascending aorta, propagates down), II (ascending aorta only, III (descending aorta only)
• Associated With:
  Marfan's syndrome
  Bicuspid aortic valve
  Coarctation of the aorta
  Pregnancy