Mukherjee Debabrata, Eagle Kim A
Cardiac Catheterization Laboratories, University of Kentucky, KY, USA.
Curr Probl Cardiol. 2005 Jun;30(6):287-325. doi: 10.1016/j.cpcardiol.2005.01.002.
Acute aortic dissection is a medical emergency with high morbidity and mortality requiring emergent diagnosis and therapy. Rapid advances in noninvasive imaging technology have facilitated the early diagnosis of this condition and should be considered in the differential diagnosis of any patient with chest, back, or abdominal pain. Emergent surgery is the treatment for patients with type A dissection while optimal medical therapy is appropriate in patients with uncomplicated type B dissection. Adequate beta-blockade is the cornerstone of medical therapy. Patients who survive acute aortic dissection need long-term medical therapy with beta-blockers and statins and appropriate serial imaging follow-up. Future advances in this field include biomarkers in the early diagnosis of acute aortic dissection and presymptomatic diagnosis with genetic screening. Overall patients with aortic dissection are at high risk for an adverse outcome and need to be managed aggressively in hospital and long term with frequent follow-up.
急性主动脉夹层是一种具有高发病率和死亡率的医疗急症，需要紧急诊断和治疗。无创成像技术的迅速发展促进了对这种疾病的早期诊断，对于任何有胸痛、背痛或腹痛的患者进行鉴别诊断时都应考虑该技术。急诊手术是A型夹层患者的治疗方法，而对于无并发症的B型夹层患者，最佳药物治疗是合适的。充分的β受体阻滞剂治疗是药物治疗的基石。急性主动脉夹层存活的患者需要长期使用β受体阻滞剂和他汀类药物进行药物治疗，并进行适当的系列影像学随访。该领域未来的进展包括急性主动脉夹层早期诊断中的生物标志物以及通过基因筛查进行症状前诊断。总体而言，主动脉夹层患者发生不良结局的风险很高，需要在医院进行积极管理，并长期频繁随访。
