Acute Aortic Disease (Fundamental and Clinical Cardiology) by John Elefteriades

By John Elefteriades

Protecting the pathophysiology, imaging, prognosis, and therapy of a number of aortic aneurysms and dissections, this resource is helping physicians successfully study and assessment affected contributors in scientific or emergency care settings. delivering a wide range of illustrations, x-rays, and operative images to stress key anatomic observations, this consultant includes state of the art perception at the most recent biologic, radiologic, scientific, and surgical advancements that experience taken position within the box. provided in a reader-friendly layout, this resource offers end-of-chapter questions and a point-counterpoint structure to investigate differing views from popular specialists on those illnesses. The Q & A and counterpoint contain the reader in an interactive interchange by way of opinion leaders.

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Midterm follow-up of penetrating ulcer and intramural hematoma of the aorta. J Thorac Cardiovasc Surg 2002; 123:1051−1059. indd28 28 2/14/2007 5:51:22 PM SECTION II: IMAGING AND DIAGNOSIS 2 The Symptoms and Signs of Acute Aortic Dissection: Clinical Diagnosis of “The Great Masquerader” Eric M. A. INTRODUCTION There is a “classic” constellation of symptoms and signs of acute aortic dissection that is commonly taught in medical school. One classic example would be a 72 year-old man with a history of longstanding hypertension, who presents with the acute onset of severe stabbing, interscapular back pain; on arrival he is diaphoretic and restless, with a blood pressure of 195/110 mmHg.

In addition, the proximal segment of the aortic wall is known to lose distensibility with hypertension or increasing age. In this context, aortic regurgitation and the fluid dynamics of a bicuspid aortic valve may relate to these pathophysiologic mechanisms. CONCLUSION With the historic evolution of different classifications of aortic dissection, various prognostic mechanisms and management strategies have eventually emerged. The medical community faces the responsibility to integrate the clinical complexity of the disorder, improving classification algorithms and eventually understanding aortic dissection better via improved classification.

32. Moles VP, Chappuis F, Simonet F, et al. Aortic dissection as complication of percutaneous transluminal coronary angioplasty. Catheter Cardiovasc Diagn 1992; 26:8–11. 33. Januzzi J, Sabatine MS, Eagle KA, et al. Iatrogenic aortic dissection. Am J Cardiol 2002; 89:623–626. indd21 21 2/14/2007 5:51:21 PM 22 Nienaber and Ince 34. Pieters FAA, Widdershoven JW, Gerardy AC, et al. Risk of aortic dissection after aortic valve replacement. Am J Cardiol 1993; 72:1043–1047. 35. Epperlein S, Mohr-Kahaly S, Erbel R, et al.

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