Type A Aortic Dissection Complicated by Renal and Lower Extremity Malperfusion

被引:2
作者
Gargotta, Hillary R. [1 ]
机构
[1] Univ Texas Southwestern Med Ctr Dallas, Dept Emergency Med, Dallas, TX 75390 USA
关键词
aortic dissection; limb ischemia; malperfusion syndrome; renal ischemia; INTERNATIONAL REGISTRY; MANAGEMENT; DIAGNOSIS; OUTCOMES;
D O I
10.1097/TME.0000000000000220
中图分类号
R47 [护理学];
学科分类号
1011 ;
摘要
Acute aortic dissection is a life-threatening condition with the potential for serious complications such as myocardial infarction, heart failure, stroke, paraplegia, renal failure, mesenteric ischemia, and limb ischemia. Emergency department clinicians must be aware of the potential ischemic complications of aortic dissection and act quickly to prevent irreversible organ damage and death. This article highlights a case of a 49-year-old man who developed renal and lower extremity malperfusion secondary to Stanford Type A aortic dissection. Important historical clues and objective findings characteristic of acute aortic dissection and end-organ ischemia are discussed with the purpose of increasing reader knowledge of aortic dissection and signs of organ malperfusion with the hope that better awareness results in improved patient outcomes.
引用
收藏
页码:23 / 32
页数:10
相关论文
共 14 条
[1]   Chest radiography in acute aortic syndrome: pearls and pitfalls [J].
Chawla A. ;
Rajendran S. ;
Yung W.H. ;
Babu S.B. ;
Peh W.C. .
Emergency Radiology, 2016, 23 (4) :405-412
[2]   Clinical presentation, management, and short-term outcome of patients with type A acute dissection complicated by mesenteric malperfusion: Observations from the International Registry of Acute Aortic Dissection [J].
Di Eusanio, Marco ;
Trimarchi, Santi ;
Patel, Himanshu J. ;
Hutchison, Stuart ;
Suzuki, Toru ;
Peterson, Mark D. ;
Di Bartolomeo, Roberto ;
Folesani, Gianluca ;
Pyeritz, Reed E. ;
Braverman, Alan C. ;
Montgomery, Daniel G. ;
Isselbacher, Eric M. ;
Nienaber, Christoph A. ;
Eagle, Kim A. ;
Fattori, Rossella .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2013, 145 (02) :385-U417
[3]   2014 ESC Guidelines on the diagnosis and treatment of aortic diseases [J].
Erbel, Raimund ;
Aboyans, Victor ;
Boileau, Catherine ;
Bossone, Eduardo ;
Di Bartolomeo, Roberto ;
Eggebrecht, Holger ;
Evangelista, Arturo ;
Falk, Volkmar ;
Frank, Herbert ;
Gaemperli, Oliver ;
Grabenwoeger, Martin ;
Haverich, Axel ;
Iung, Bernard ;
Manolis, Athanasios John ;
Meijboom, Folkert ;
Nienaber, Christoph A. ;
Roffi, Marco ;
Rousseau, Herve ;
Sechtem, Udo ;
Sirnes, Per Anton ;
von Allmen, Regula S. ;
Vrints, Christiaan J. M. .
EUROPEAN HEART JOURNAL, 2014, 35 (41) :2873-U93
[4]   Differential outcomes of type A dissection with malperfusion according to affected organ system [J].
Grimm, Joshua C. ;
Magruder, J. Trent ;
Crawford, Todd C. ;
Sciortino, Christopher M. ;
Zehr, Kenton J. ;
Mandal, Kaushik ;
Conte, John V. ;
Cameron, Duke E. ;
Black, James H. ;
Price, Joel E. .
ANNALS OF CARDIOTHORACIC SURGERY, 2016, 5 (03) :202-208
[5]   Correlates of Delayed Recognition and Treatment of Acute Type A Aortic Dissection The International Registry of Acute Aortic Dissection (IRAD) [J].
Harris, Kevin M. ;
Strauss, Craig E. ;
Eagle, Kim A. ;
Hirsch, Alan T. ;
Isselbacher, Eric M. ;
Tsai, Thomas T. ;
Shiran, Hadas ;
Fattori, Rossella ;
Evangelista, Arturo ;
Cooper, Jeanna V. ;
Montgomery, Daniel G. ;
Froehlich, James B. ;
Nienaber, Christoph A. .
CIRCULATION, 2011, 124 (18) :1911-U82
[6]  
Hiratzka LF, 2010, CIRCULATION, V121, pE266, DOI 10.1161/CIR.0b013e3181d4739e
[7]   Population-Based Study of Incidence and Outcome of Acute Aortic Dissection and Premorbid Risk Factor Control 10-Year Results From the Oxford Vascular Study [J].
Howard, Dominic P. J. ;
Banerjee, Amitava ;
Fairhead, Jack F. ;
Perkins, Jeremy ;
Silver, Louise E. ;
Rothwell, Peter M. .
CIRCULATION, 2013, 127 (20) :2031-+
[8]   Visceral Malperfusion in Aortic Dissection: The Michigan Experience [J].
Kamman, Arnoud V. ;
Yang, Bo ;
Kim, Karen M. ;
Williams, David M. ;
Deeb, George Michael ;
Patel, Himanshu J. .
SEMINARS IN THORACIC AND CARDIOVASCULAR SURGERY, 2017, 29 (02) :173-178
[9]   Guidelines for the management of thoracic aortic disease in 2017 [J].
Mokashi, Suyog A. ;
Svensson, Lars G. .
GENERAL THORACIC AND CARDIOVASCULAR SURGERY, 2019, 67 (01) :59-65
[10]   Acute aortic dissection: Epidemiology and outcomes [J].
Pacini, Davide ;
Di Marco, Luca ;
Fortuna, Daniela ;
Belotti, Laura Maria Beatrice ;
Gabbieri, Davide ;
Zussa, Claudio ;
Pigini, Florio ;
Contini, Andrea ;
Barattoni, Maria Cristina ;
De Palma, Rossana ;
Di Bartolomeo, Roberto .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2013, 167 (06) :2806-2812