Document Detail


Acute aortic emergencies-part 2 aortic dissections.
MedLine Citation:
PMID:  23364404     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Patients with aortic disease are some of the highest acuity patients that emergency clinicians encounter. Dissection is the most common aortic catastrophe and involves separation of the aortic layers in a longitudinal fashion leading to diminished perfusion and systemic ischemia. Characteristics of pain, branch vessel involvement, and incidence lead to an understanding of patient presentation, morbidity, and mortality. Diagnosis, selection of diagnostic studies, the degree of preoperative ischemia, and risk of operative mortality can be accomplished using validated clinical decision tools. Emergency interventions are guided by the type of dissection according to the Stanford classification system. Medical management includes pain control and anti-impulse, antihypertensive therapy through vasodilatation and blockage of the sympathetic β-response. The patient may then be evaluated for open surgical intervention, aortic fenestration, endovascularly placed stent grafts, or a combination possibly in a staged approach. Morbidity includes rupture, stroke, paraplegia, acute renal failure, bowel ischemia, and peripheral ischemia.
Authors:
Ann White; Joshua Broder; Jennifer Mando-Vandrick; Jonathan Wendell; Jennifer Crowe
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Advanced emergency nursing journal     Volume:  35     ISSN:  1931-4493     ISO Abbreviation:  Adv Emerg Nurs J     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101285075     Medline TA:  Adv Emerg Nurs J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  28-52     Citation Subset:  IM; N    
Affiliation:
Department of Advanced Clinical Practice, Duke University Hospital, Duke University School of Nursing (Ms White), Emergency Department, Duke University Hospital (Ms Crowe), Department of Pharmacy, Duke University Hospital (Dr Mando-Vandrick), and Division of Emergency Medicine, Duke University Medical Center (Drs Broder and Wendell), Durham, NC.
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