Aortic Dissection

Aortic dissection is a diagnosis that should be strongly suspected if the appropriate features are present upon clinical assessment: the history (tearing pain), examination (new murmur of aortic regurgitation, differential blood pressures), ECG (inferior ischaemic changes) and CXR (widened mediastinum) will, when present in combination, be pathognomonic of aortic dissection. However, due to the potentially catastrophic nature of aortic dissection if undiagnosed, this condition will need to be definitively excluded even if the index of suspicion is low (e.g. if only one of the characteristic clinical features is present). In patients in whom the diagnosis is virtually certain from the clinical presentation, the anatomical extent of the dissection will need to be defined. In either case, a CT angiogram of the aorta will need to be performed and this will be diagnostic and define the anatomical extent.

Learning Bite

CT angiogram of the aorta will be required to definitively exclude aortic dissection and/or to define its’ anatomical extent