![]() ![]() Type A involves the ascending aorta and may progress to involve the aortic arch and thoracoabdominal aorta.There is also the DeBakey Classification, which subdivides aortic dissections as class I, II, IIIa, and IIIb as pictured below. In the Stanford Classification, dissections are classified into two groups – those that involve the ascending aorta and/or aortic arch (Stanford Type A), and those that originate only distal to the brachiocephalic artery, including the abdominal aorta (Stanford Type B). The presence of an intimal flap in the aortic lumen is used to diagnose aortic dissection using ultrasound (Siegal). Using the techniques for visualizing the abdominal and thoracic aorta described above, you may detect a free flap in the aortic lumen. Unfortunately, aortic dissections are one of the most difficult diagnoses to make since the symptoms can vary from chest pain, abdominal pain, to neurologic deficits depending on what parts of the aorta the dissection involves. The dissection can travel in an anterograde or retrograde direction. Pulse deficit, systolic BP differential between limbsĪn aortic dissection occurs when a tear in the arterial intima allows blood, under high systolic pressures, to dissect along the arterial media and create a “false lumen” in the aorta. Signs of GI bleeding or retroperitoneal hemorrhage Pain, hypotension, pulsatile abdominal mass (ruptured AAA classic triad) However, keep in mind that patients with congenital risk factors will commonly present before age 40 (Lederle, Howard).īelow is a table to keep in mind when considering Abdominal Aortic Aneurysm (AAA) or Aortic Dissection:Ĭonstant, intense abdominal, back, pelvic, or flank pain that may radiate to buttocks, groin, or thighsĪcute-onset, severe chest or back pain with ripping/tearing/sharp or stabbing qualityĪtherosclerosis & coronary artery diseaseĬonnective tissue disease (Ehler’s-Danlos, Marfan’s) Male sex and advanced age (≥ 65) are considered risk factors for both AAA and aortic dissection.The US preventative task force recommends a one-time screening for AAA in male patients between the ages of 65-75 who have ever smoked.You should conduct an ultrasound of the aorta whenever you suspect abdominal aortic aneurysm (AAA) or aortic dissection. Indications for Performing Aorta Ultrasound Descending Aorta View of Aortic Dissection.Suprasternal Notch View of Aortic Dissection.Parasternal Long Axis View of Aortic Dissection.Abdominal Aortic Aneurysm (AAA) on Ultrasound.Obtain a Longitudinal View of the Thoracic Aorta. ![]() Position your Probe in the Suprasternal Notch. Step by Step Suprasternal View of the Aortic Arch.Visualize the Celiac trunk and SMA in the Longitudinal View Orient the Probe in the Long Axis/Sagittal Plane Abdominal Aorta Ultrasound Protocol: Long Axis.Abdominal Aortic bifurcation: the common iliac arteries Abdominal Aorta Ultrasound Protocol: Short Axis.Indications for Performing Aorta Ultrasound.Recognize Abdominal Aortic Aneurysm (AAA) and Aortic Dissection using ultrasound.Obtain a Suprasternal Notch View of the thoracic aorta.Obtain a Long Axis view of the abdominal aorta.Obtain Short Axis views of the proximal, mid, and distal abdominal aorta.Learn how to scan the Aorta using ultrasound.When performed properly, point-of-care ultrasound (POCUS) is an invaluable tool to quickly and accurately screen for these life-threatening conditions.Īfter reading this post, you will be able to: What’s more, aortic diseases often present with nonspecific and misleading symptoms (when symptoms are even present), making a speedy diagnosis essential. However, when left untreated, they are often fatal – mortality in ruptured AAA is between 85-90% (Kent). High-risk vascular emergencies like abdominal aortic aneurysm (AAA) and aortic dissection can be fairly prevalent in developed countries. Oversight, Review, and Final Edits by Vi Dinh (POCUS 101 Editor). Primary Authors: Devin Tooma, Vi Dinh Co-authors: Jessica Ahn, Jade Deschamps, Satchel Genobaga, Annalise Lang, Victor Lee, Reed Krause, Seth White. Cardiac Output and Stroke Volume Calculator.Machine Basics-Knobology, Probes, Modes. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |