Acute Aortic Syndromes: Diagnostic and Therapeutic Pathways

Heart Fail Clin. 2020 Jul;16(3):305-315. doi: 10.1016/j.hfc.2020.03.002.

Abstract

Acute aortic syndromes are life-threatening medical conditions that include classic acute aortic dissection (AAD), aortic intramural hematoma, penetrating aortic ulcer, and even aortic pseudoaneurysm and traumatic aortic injury. The European Society of Cardiology has designed a multiparametric diagnostic algorithm to provide stepwise diagnosis. All patients with AAD should receive aggressive medical therapy to control blood pressure and heart rate. Urgent surgical repair is recommended for type A AAD. Uncomplicated type B AAD requires aggressive medical therapy. In contrast thoracic endovascular repair is recommended for complicated type B. AAD should be considered a lifelong disease that affects the entire aorta.

Keywords: Acute aortic syndromes; Aortic dissection; Intramural hematoma; Multiparametric diagnostic algorithm; Penetrating aortic ulcer; Surgical repair; Thoracic endovascular aortic repair.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Aortic Diseases* / classification
  • Aortic Diseases* / diagnosis
  • Aortic Diseases* / physiopathology
  • Aortic Diseases* / therapy
  • Cardiovascular Surgical Procedures / methods*
  • Emergency Treatment / methods*
  • Endovascular Procedures / methods*
  • Humans
  • Multimodal Imaging