This review outlines the critical diagnostic and management strategies for acute aortic dissection, emphasizing urgent surgery for ascending dissection and strict blood pressure/heart rate control for descending dissection.
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Reaffirms type-specific acute aortic dissection care; leaves open need for prospective trials on optimized regimens.
Aortic dissection is a rare condition that frequently manifests suddenly as a catastrophic sickness with intense back or chest pain that is ripping, along with acute hemodynamic compromise. For survival, early and precise diagnosis and treatment are essential. An urgent need for heart surgery is acute ascending thoracic aortic dissection. In stable patients, acute descending thoracic aortic dissection is treated medically, but endovascular interventions may be needed if persistent pain, dissection progression and end-organ ischemia. Acute medical management includes pain control and anti-impulse therapy to reduce the velocity of LV contraction and decrease shear stress by giving antihypertensive therapy (target BP 100 to 120mmHg) typically using IV beta blockers with a target HR of less than 60.
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Nehmat Ahmad (2023) studied this question.
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