1. Dissection of the aorta.
2. Systemic hypertension (present in over
90% of cases of dissection), cystic medial necrosis, Marfan's syndrome.
Aortic dissection is NOT usually associated with aortic dilatation.
3. Dissection usually originates with an
intimal tear which allows blood into the media. It can then dissect
proximally towards the heart or distally to involve branches of the aorta.
It can rupture into the pericardial sac or cavities. About 20% of cases will
show focal cystic medial necrosis in the wall (Figure 2).
Hypertension may predispose patients to
cystic medial necrosis.
4. Complications include:
A) occlusion of aortic branches
B) aortic valvular insufficiency
C) obstruction of pulmonary artery
D) rupture, with exangination
E) cardiac tamponade
5.
Occasionally the dissection can rupture back
into the lumen and lead to two functional lumina (double barreled aorta).
