Complications

These will vary according to the site of the tear and the extent of the dissection.

• neurological complications
  • more common in type A
  • include stroke, spinal cord ischemia, ischemic neuropathy, and hypoxic encephalopathy
• syncope
  • seen in in 9% of patients
  • causes may include cardiac tamponade, aortic rupture, cerebral vessel obstruction, or activation of cerebral baroreceptors
• cardiac complications - most frequently involved end organ
  • acute aortic regurgitation - common in type a dissections occurring in 41% to 76% of cases
  • acute myocardial infarction or coronary ischemia
    • may mask the diagnosis of dissection and delay the recognition and treatment of the condition or lead to inappropriate use of antiplatelet and anticoagulant therapy (1)
  • Pericardial tamponade
• pulmonary complications - pleural effusion
• gastrointestinal complications - mesenteric ischemia,
• limb ischemia

Reference:

• (1) Braverman AC. Acute aortic dissection: clinician update. Circulation. 2010;122(2):184-8.