Aortic dissection

Alternative names:

aortic aneurysm (dissecting)

Symptoms:

• chest pain
  • sudden, severe
  • sharp, stabbing, tearing, or ripping
  • located below the sternum, under the shoulder blades, or in the back
  • pain may radiate to shoulder, neck, arm, jaw, abdomen, hips
  • location of pain may change

• changes in thought ability, concentration (confusion, disorientation)
• decreased movement, any location
• decreased sensation, any location
• anxiety
• pallor
• rapid pulse (heart rate)
• profuse sweating
• dry skin/mouth, thirst
• nausea, vomiting
• dizziness, fainting
• shortness of breath (dyspnea)
  • difficulty breathing when flat (orthopnea)
  • difficulty breathing at night (paroxysmal nocturnal dyspnea)

Note: Symptoms may begin suddenly.

Additional symptoms that may be associated with this disease:

• yawning, excessive
• skin, clammy
• pulse, weak or absent
• cough
• blood pressure, high

Signs and tests:

Listening with a stethoscope (auscultation) at the chest and abdomen may reveal a "blowing" murmur over the aorta, a heart murmur, or other abnormality. There may be decreased (weak) pulses in the upper extremities. There may be signs of tamponade or hypovolemia, or signs resembling acute MI. There may be signs of shock but with normal blood pressure.

Aortic dissection or aortic aneurysm may be revealed on:

• an aortic angiography
• a chest MRI or CT scan of chest
• an echocardiography
• a chest X-ray (may show mediastinal widening)
• a Doppler ultrasonography (occasionally performed)
• ECG may show signs of cardiac tamponade.
• CBC is performed to evaluate blood loss.