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  #1  
Old 05-21-2012
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Heart Steps of management of Aortic Dissection

Is this algorithm right?--for aortic dissection management---

Acute chest pain suggestive of dissection-> AHTN -> CXR->
? stable -> Chest CT with contrast
? unstable -> TTE

comments?
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  #2  
Old 05-21-2012
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yeah the Mx is correct as far as I know.
After suspecting a pt for aortic dissection, first step is to lower BP and then do a X-ray. If widened mediastinum, proceed with CT contrast/ TEE/ MRA if pt is stable. If unstable proceed with a TTE (non invasive procedure).
The most accurate test is however Angiography.
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tyagee (05-22-2012)
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Old 05-22-2012
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in Uworld

i found one question mention unstable pt in which the question gives u that TTE is done and dx dissection !?

in other question it was about the first step in suspect case with HTN >> anti-hypertensive men. and i found in explanation
Choice (B). TEE is the initial investigation of choice to diagnose suspected aortic dissection. But it is indicated only after hypertension treatment is initiated.
Choice (C): Transthoracic echocardiogram is not used to diagnose aortic dissection.
Choice (F) Chest - X ray also reveals aortic dissection as mediastinal enlargement but still not the 1st step in this patient.

So TTE has no role in unstable pt
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Old 05-22-2012
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and i'm thinking what make pt with aortic dissection UNSTABLE
one of 2 things, its either cardiac temponade or aortic rupture and in both cases TTE will diagnostic right
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