Michael: /* Sign out */

2014-05-19T19:17:45Z

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← Older revision		Revision as of 19:17, 19 May 2014
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	- NO SIGNIFICANT INFLAMMATION.		- NO SIGNIFICANT INFLAMMATION.
	- NO MICROORGANISMS IDENTIFIED WITH ROUTINE STAINS.		- NO MICROORGANISMS IDENTIFIED WITH ROUTINE STAINS.
			- NO EVIDENCE OF CYSTIC MEDIAL DEGENERATION, SEE COMMENT.

	COMMENT:		COMMENT:

Michael at 17:14, 16 May 2014

2014-05-16T17:14:45Z

← Older revision		Revision as of 17:14, 16 May 2014
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	*[http://path.upmc.edu/cases/case84.html Aortic dissection - autopsy (upmc.edu)].		*[http://path.upmc.edu/cases/case84.html Aortic dissection - autopsy (upmc.edu)].
	*[http://library.med.utah.edu/WebPath/CVHTML/CV029.html Aortic dissection (utah.edu)].		*[http://library.med.utah.edu/WebPath/CVHTML/CV029.html Aortic dissection (utah.edu)].

			==Stains==
			*[[Alcian blue]]-[[PAS]] - no ground substance - see ''[[cystic medial degeneration]]''.
			*[[Elastin stain]] - no extensive fragmentation of the elastin fibres.

			==Sign out==
			<pre>
			PORTION OF AORTA, EXCISION/REPAIR:
			- AORTIC WALL WITH EVIDENCE OF DISSECTION.
			- NO SIGNIFICANT INFLAMMATION.
			- NO MICROORGANISMS IDENTIFIED WITH ROUTINE STAINS.

			COMMENT:
			An elastic staining does not demonstrate fragmentation of the elastin fibres. No
			degenerative changes of the media are apparent with Alcian blue-PAS staining.
			</pre>

	==See also==		==See also==

Michael at 13:08, 13 May 2014

2014-05-13T13:08:29Z

← Older revision		Revision as of 13:08, 13 May 2014
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	Note:		Note:
	*Diabetes uncommon in thoracic aortic dissection.<ref name=pmid21173794/>		*[[Diabetes]] uncommon in thoracic aortic dissection.<ref name=pmid21173794/>

	May be separated into two groups:<ref>URL: [http://path.upmc.edu/cases/case84/dx.html http://path.upmc.edu/cases/case84/dx.html]. Accessed on: 13 May 2014.</ref>		May be separated into two groups:<ref>URL: [http://path.upmc.edu/cases/case84/dx.html http://path.upmc.edu/cases/case84/dx.html]. Accessed on: 13 May 2014.</ref>

Michael: split out

2014-05-13T13:07:32Z

split out

← Older revision		Revision as of 13:07, 13 May 2014
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	~~#redirect [[Vascular_disease#Aortic_dissection]]~~		'''Aortic dissection''', abbreviated '''AoD''', is an uncommon condition with a relatively high mortality.

			==General==
			Risk factors:
			*[[Hypertension]].<ref name=pmid21968475>{{Cite journal \| last1 = Braverman \| first1 = AC. \| title = Aortic dissection: prompt diagnosis and emergency treatment are critical. \| journal = Cleve Clin J Med \| volume = 78 \| issue = 10 \| pages = 685-96 \| month = Oct \| year = 2011 \| doi = 10.3949/ccjm.78a.11053 \| PMID = 21968475 \| URL = http://www.ccjm.org/content/78/10/685.long }}</ref>
			*[[Atherosclerosis]].<ref name=pmid21173794>{{Cite journal \| last1 = LeMaire \| first1 = SA. \| last2 = Russell \| first2 = L. \| title = Epidemiology of thoracic aortic dissection. \| journal = Nat Rev Cardiol \| volume = 8 \| issue = 2 \| pages = 103-13 \| month = Feb \| year = 2011 \| doi = 10.1038/nrcardio.2010.187 \| PMID = 21173794 }}</ref>
			**[[Smoking]].
			*Cardiac surgery - rare, well-known complication.<ref name=pmid22345184>{{Cite journal \| last1 = Leontyev \| first1 = S. \| last2 = Borger \| first2 = MA. \| last3 = Legare \| first3 = JF. \| last4 = Merk \| first4 = D. \| last5 = Hahn \| first5 = J. \| last6 = Seeburger \| first6 = J. \| last7 = Lehmann \| first7 = S. \| last8 = Mohr \| first8 = FW. \| title = Iatrogenic type A aortic dissection during cardiac procedures: early and late outcome in 48 patients. \| journal = Eur J Cardiothorac Surg \| volume = 41 \| issue = 3 \| pages = 641-6 \| month = Mar \| year = 2012 \| doi = 10.1093/ejcts/ezr070 \| PMID = 22345184 }}</ref>
			**In one large registry, approximately 15% of acute dissections are associated with prior cardiac surgery.<ref name=pmid24030404>{{cite journal \|author=Teman NR, Peterson MD, Russo MJ, ''et al.'' \|title=Outcomes of patients presenting with acute type A aortic dissection in the setting of prior cardiac surgery: an analysis from the International Registry of Acute Aortic Dissection \|journal=Circulation \|volume=128 \|issue=11 Suppl 1 \|pages=S180–5 \|year=2013 \|month=September \|pmid=24030404 \|doi=10.1161/CIRCULATIONAHA.112.000342 \|url=}}</ref>

			Note:
			*Diabetes uncommon in thoracic aortic dissection.<ref name=pmid21173794/>

			May be separated into two groups:<ref>URL: [http://path.upmc.edu/cases/case84/dx.html http://path.upmc.edu/cases/case84/dx.html]. Accessed on: 13 May 2014.</ref>
			#Hypertension + atherosclerosis, typically 40-60 years old.
			#Connective tissue disorders - "young".

			===Associations===
			Heritable:<ref name=pmid16253833>{{cite journal \|author=Gleason TG \|title=Heritable disorders predisposing to aortic dissection \|journal=Semin. Thorac. Cardiovasc. Surg. \|volume=17 \|issue=3 \|pages=274-81 \|year=2005 \|pmid=16253833 \|doi=10.1053/j.semtcvs.2005.06.001 \|url=}}</ref>
			*[[Marfan's syndrome]].
			*Loeys-Dietz syndrome - a Marfan-like syndrome<ref name=pmid16928994>{{cite journal \|author=Loeys BL, Schwarze U, Holm T, ''et al'' \|title=Aneurysm syndromes caused by mutations in the TGF-beta receptor \|journal=N. Engl. J. Med. \|volume=355 \|issue=8 \|pages=788-98 \|year=2006 \|month=August \|pmid=16928994 \|doi=10.1056/NEJMoa055695 \|url=http://content.nejm.org/cgi/content/full/355/8/788}}</ref>
			*[[Ehlers-Danlos syndrome]].
			*[[Bicuspid aortic valve]].<ref name=pmid21173794/>

			Others:
			*Tertiary [[syphilis]].<ref name=pmid20864080>{{Cite journal \| last1 = Cruz \| first1 = RP. \| last2 = Marrone \| first2 = LC. \| last3 = Marrone \| first3 = AC. \| title = Chronic syphilitic aortic aneurysm complicated with chronic aortic dissection. \| journal = Am J Surg \| volume = 200 \| issue = 5 \| pages = e64-6 \| month = Nov \| year = 2010 \| doi = 10.1016/j.amjsurg.2010.02.017 \| PMID = 20864080 }}</ref>
			*[[Turner syndrome]].<ref name=pmid21731587>{{Cite journal \| last1 = Carlson \| first1 = M. \| last2 = Silberbach \| first2 = M. \| title = Dissection of the aorta in Turner syndrome: two cases and review of 85 cases in the literature. \| journal = BMJ Case Rep \| volume = 2009 \| issue = \| pages = bcr0620091998 \| month = \| year = 2009 \| doi = 10.1136/bcr.06.2009.1998 \| PMID = 21731587 }}</ref>

			===Classification===
			Two classification exist:
			*''DeBakey''.
			*''Stanford''.

			Stanford dissection classification:<ref name=pmid9362838>{{cite journal \|author=Finkelmeier BA \|title=Dissection of the aorta: a clinical update \|journal=J Vasc Nurs \|volume=15 \|issue=3 \|pages=88-93 \|year=1997 \|month=September \|pmid=9362838 \|doi= \|url=}}</ref>
			*Type A - aortic root to the left subclavian artery.
			**Considered a surgical emergency.
			*Type B - distal to (left) subclavian artery.
			**Generally, treated conservatively.

			==Gross==
			*Entry intimal tear +/- exit intimal tear.
			**Blood between layers of the vessel wall.

			===Images===
			<gallery>
			Image:AoDiss_Patho.jpg \| Aortic dissection. (WC)
			</gallery>

			www:
			*[http://library.med.utah.edu/WebPath/CVHTML/CV031.html Aortic dissection (utah.edu)].
			*[http://www.brown.edu/Courses/Digital_Path/systemic_path/cardio/ad-gross.html Aortic dissection (brown.edu)].

			==Microscopic==
			Features:
			*Defect in the tunica media (muscle layer).
			*"Abundant" fresh blood in the adventitia.
			*+/-Changes of [[cystic medial degeneration]] - a specific histopathologic cause of aortic dissection.

			DDx:
			*[[Cystic medial degeneration]].

			===Images===
			<gallery>
			Image:Aortic dissection (1) Victoria blue-HE.jpg \| Aortic dissection. Victoria blue-H&E. (WC/KGH)
			</gallery>

			www:
			*[http://path.upmc.edu/cases/case84.html Aortic dissection - autopsy (upmc.edu)].
			*[http://library.med.utah.edu/WebPath/CVHTML/CV029.html Aortic dissection (utah.edu)].

			==See also==
			*[[Vascular disease]].

			==References==
			{{Reflist\|2}}

			[[Category:Vascular disease]]
	[[Category:Diagnosis]]		[[Category:Diagnosis]]

Michael: redirect w/ cat

2011-11-28T01:10:21Z

redirect w/ cat

New page

#redirect [[Vascular_disease#Aortic_dissection]]

[[Category:Diagnosis]]

Aortic dissection - Revision history

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Michael at 17:14, 16 May 2014

Michael at 13:08, 13 May 2014

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