Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK.
Department of Medicine, Chicago Medical School, Rosalind Franklin University of Medicine and Sciences, North Chicago, IL, USA.
Br J Hosp Med (Lond). 2024 Jul 30;85(7):1-12. doi: 10.12968/hmed.2024.0004. Epub 2024 Jul 25.
Acute aortic dissection is a cardiovascular emergency that should be recognised on presentation in the Emergency Department (ED) because clinical outcome is time-dependent. In suspected cases of acute aortic dissection, immediate imaging with chest computed tomography scan followed by transthoracic echocardiography (TTE) is essential to confirm diagnosis. Immediate medical management is aimed at controlling the heart rate (60-80 beats/min), systolic blood pressure (100-120 mmHg) and pain. Patients with Type A acute aortic dissection should immediately be referred to the cardiothoracic surgeons for emergency aortic surgery while those with Type B acute aortic dissection should be referred to the vascular surgeons for surgical/endovascular interventions if indicated.
急性主动脉夹层是一种心血管急症，在急诊科就诊时应予以识别，因为临床结局取决于时间。对于疑似急性主动脉夹层的病例，应立即进行胸部计算机断层扫描成像，然后进行经胸超声心动图（TTE）检查，以明确诊断。立即进行医疗管理，旨在控制心率（60-80 次/分）、收缩压（100-120mmHg）和疼痛。对于 A 型急性主动脉夹层患者，应立即转介至心胸外科医生进行紧急主动脉手术，而对于 B 型急性主动脉夹层患者，如果有指征，应转介至血管外科医生进行手术/血管内介入治疗。
