Acute aortic dissection is a life-threatening condition, andits prompt diagnosis remains essential for successful management.Although early mortality may be as high as 1 percent per hour1among untreated patients, survival can be improved by the rapidinstitution of appropriate medical or surgical therapy (or both).The Stanford classification system2 divides aortic dissectionsanatomically into two types on the basis of location. A dissectionin which there is involvement of the ascending aorta, regardlessof the site of entry, is defined as type A (this includes DeBakey3 types I and II and is often described as a proximal . . . [Full Text of this Article]
Aortography
CT Scanning
MRI
Echocardiography
Selecting a Method of Imaging
Source Information
From the Cardiac Unit, Massachusetts General Hospital, Boston.
Address reprint requests to Dr. Eagle at ACC 469, Massachusetts General Hospital, 15 Parkman St., Boston, MA 02114.
References
This article has been cited by other articles:
Lin, P. H., Huynh, T. T., Kougias, P., Huh, J., LeMaire, S. A., Coselli, J. S.
(2009). Descending Thoracic Aortic Dissection: Evaluation and Management in the Era of Endovascular Technology. VASC ENDOVASCULAR SURG
43: 5-24
[Abstract]
Pierard, L. A, Lancellotti, P.
(2009). Echocardiography in the emergency room: Non-invasive imaging. Heart
95: 164-170
[Full Text]
Patel, P. D., Arora, R. R.
(2008). Pathophysiology, diagnosis, and management of aortic dissection. Ther Adv Cardiovasc Dis
2: 439-468
[Abstract]
2006 WRITING COMMITTEE MEMBERS, , Bonow, R. O., Carabello, B. A., Chatterjee, K., de Leon, A. C. Jr, Faxon, D. P., Freed, M. D., Gaasch, W. H., Lytle, B. W., Nishimura, R. A., O'Gara, P. T., O'Rourke, R. A., Otto, C. M., Shah, P. M., Shanewise, J. S.
(2008). 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation
118: e523-e661
[Full Text]
Bonow, R. O., Carabello, B. A., Chatterjee, K., de Leon, A. C. Jr, Faxon, D. P., Freed, M. D., Gaasch, W. H., Lytle, B. W., Nishimura, R. A., O'Gara, P. T., O'Rourke, R. A., Otto, C. M., Shah, P. M., Shanewise, J. S., Nishimura, R. A., Carabello, B. A., Faxon, D. P., Freed, M. D., Lytle, B. W., O'Gara, P. T., O'Rourke, R. A., Shah, P. M.
(2008). 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol
52: e1-e142
[Full Text]
Muraoka, N., Sakai, T., Kimura, H., Uematsu, H., Tanase, K., Yokoyama, O., Itoh, H.
(2008). Rare Causes of Hematuria Associated with Various Vascular Diseases Involving the Upper Urinary Tract. RadioGraphics
28: 855-867
[Abstract][Full Text]
Gleason, T. G., Bavaria, J. E.
(2008). Trauma to the Great Vessels. Card Surg Adult
3: 1333-1354
[Full Text]
Liu, Q., Lu, J. P., Wang, F., Wang, L., Tian, J. M.
(2007). Three-dimensional Contrast-enhanced MR Angiography of Aortic Dissection: A Pictorial Essay. RadioGraphics
27: 1311-1321
[Abstract][Full Text]
Bonow, R. O., Carabello, B. A., Chatterjee, K., de Leon, A. C. Jr, Faxon, D. P., Freed, M. D., Gaasch, W. H., Lytle, B. W., Nishimura, R. A., O'Gara, P. T., O'Rourke, R. A., Otto, C. M., Shah, P. M., Shanewise, J. S., Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Faxon, D. P., Fuster, V., Halperin, J. L., Hiratzka, L. F., Hunt, S. A., Lytle, B. W., Nishimura, R., Page, R. L., Riegel, B.
(2006). ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol
48: e1-e148
[Full Text]
Bonow, R. O., Carabello, B. A., Chatterjee, K., de Leon, A. C. Jr, Faxon, D. P., Freed, M. D., Gaasch, W. H., Lytle, B. W., Nishimura, R. A., O'Gara, P. T., O'Rourke, R. A., Otto, C. M., Shah, P. M., Shanewise, J. S., Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Faxon, D. P., Fuster, V., Halperin, J. L., Hiratzka, L. F., Hunt, S. A., Lytle, B. W., Nishimura, R., Page, R. L., Riegel, B.
(2006). ACC/AHA 2006 Practice Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol
48: 598-675
[Full Text]
Domingo, E, Levy, D, Iosovich, S
(2006). Atypical presentation of aortic dissection secondary to a gunshot wound.. Emerg. Med. J.
23: e38-e38
[Abstract][Full Text]
Kasher, J. A., El-Bialy, A., Balingit, P.
(2004). Aortic Dissection: A Dreaded Disease with Many Faces. J CARDIOVASC PHARMACOL THER
9: 211-218
[Abstract]
Kapoor, V., Ferris, J. V., Fuhrman, C. R.
(2004). Intimomedial Rupture: A New CT Finding to Distinguish True from False Lumen in Aortic Dissection. Am. J. Roentgenol.
183: 109-112
[Abstract][Full Text]
Nienaber, C. A., Fattori, R., Mehta, R. H., Richartz, B. M., Evangelista, A., Petzsch, M., Cooper, J. V., Januzzi, J. L., Ince, H., Sechtem, U., Bossone, E., Fang, J., Smith, D. E., Isselbacher, E. M., Pape, L. A., Eagle, K. A., on Behalf of the International Registry of Acute A,
(2004). Gender-Related Differences in Acute Aortic Dissection. Circulation
109: 3014-3021
[Abstract][Full Text]
Motallebzadeh, R., Batas, D., Valencia, O., Chandrasekaran, V., Smith, J., Brecker, S., Jahangiri, M.
(2004). The role of coronary angiography in acute type A aortic dissection. Eur. J. Cardiothorac. Surg.
25: 231-235
[Abstract][Full Text]
Nienaber, C. A., Eagle, K. A.
(2003). Aortic Dissection: New Frontiers in Diagnosis and Management: Part II: Therapeutic Management and Follow-Up. Circulation
108: 772-778
[Full Text]
Nienaber, C. A., Eagle, K. A.
(2003). Aortic Dissection: New Frontiers in Diagnosis and Management: Part I: From Etiology to Diagnostic Strategies. Circulation
108: 628-635
[Full Text]
Yoshida, S., Akiba, H., Tamakawa, M., Yama, N., Hareyama, M., Morishita, K., Abe, T.
(2003). Thoracic Involvement of Type A Aortic Dissection and Intramural Hematoma: Diagnostic Accuracy--Comparison of Emergency Helical CT and Surgical Findings. Radiology
228: 430-435
[Abstract][Full Text]
Gleason, T. G., Bavaria, J. E.
(2003). Trauma to Great Vessels. Card Surg Adult
2: 1229-1250
[Full Text]
Patel, N. M., Noel, C. R., Weiner, B. K.
(2002). Aortic Dissection Presenting as an Acute Cauda Equina Syndrome : A Case Report. JBJS
84: 1430-1432
[Full Text]
Khan, I. A., Nair, C. K.
(2002). Clinical, Diagnostic, and Management Perspectives of Aortic Dissection*. Chest
122: 311-328
[Abstract][Full Text]
Sawhney, N. S., DeMaria, A. N., Blanchard, D. G.
(2001). Aortic Intramural Hematoma : An Increasingly Recognized and Potentially Fatal Entity. Chest
120: 1340-1346
[Abstract][Full Text]
Erbel, R., Alfonso, F., Boileau, C., Dirsch, O., Eber, B., Haverich, A., Rakowski, H., Struyven, J., Radegran, K., Sechtem, U., Taylor, J., Zollikofer, Ch., Klein, W.W., Mulder, B., Providencia, L.A.
(2001). Diagnosis and management of aortic dissection: Task Force on Aortic Dissection, European Society of Cardiology. Eur Heart J
22: 1642-1681
Nallamothu, B. K., Saint, S., Kolias, T. J., Eagle, K. A.
(2001). Of Nicks and Time. NEJM
345: 359-363
[Full Text]
Vignon, P., Spencer, K. T., Rambaud, G., Preux, P.-M., Krauss, D., Balasia, B., Lang, R. M.
(2001). Differential Transesophageal Echocardiographic Diagnosis Between Linear Artifacts and Intraluminal Flap of Aortic Dissection or Disruption. Chest
119: 1778-1790
[Abstract][Full Text]
Song, J.-K., Kim, H.-S., Kang, D.-H., Lim, T.-H., Song, M.-G., Park, S.-W., Park, S.-J.
(2001). Different clinical features of aortic intramural hematoma versus dissection involving the ascending aorta. J Am Coll Cardiol
37: 1604-1610
[Abstract][Full Text]
Batra, P., Bigoni, B., Manning, J., Aberle, D. R., Brown, K., Hart, E., Goldin, J.
(2000). Pitfalls in the Diagnosis of Thoracic Aortic Dissection at CT Angiography. RadioGraphics
20: 309-320
[Abstract][Full Text]
Hagan, P. G., Nienaber, C. A., Isselbacher, E. M., Bruckman, D., Karavite, D. J., Russman, P. L., Evangelista, A., Fattori, R., Suzuki, T., Oh, J. K., Moore, A. G., Malouf, J. F., Pape, L. A., Gaca, C., Sechtem, U., Lenferink, S., Deutsch, H. J., Diedrichs, H., Marcos y Robles, J., Llovet, A., Gilon, D., Das, S. K., Armstrong, W. F., Deeb, G. M., Eagle, K. A.
(2000). The International Registry of Acute Aortic Dissection (IRAD): New Insights Into an Old Disease. JAMA
283: 897-903
[Abstract][Full Text]
Fikar, C. R., Koch, S.
(2000). Etiologic Factors of Acute Aortic Dissection in Children and Younrg Adults. CLIN PEDIATR
39: 71-80
[Abstract]
Willens, H. J., Kessler, K. M.
(1999). Transesophageal Echocardiography in the Diagnosis of Diseases of the Thoracic Aorta* : Part 1. Aortic Dissection, Aortic Intramural Hematoma, and Penetrating Atherosclerotic Ulcer of the Aorta. Chest
116: 1772-1779
[Full Text]
Kim, M. H., Eagle, K. A., Isselbacher, E. M.
(1999). Bayesian Persuasion. Circulation
100
: e68-e72
[Full Text]
Svensson, L. G., Labib, S. B., Eisenhauer, A. C., Butterly, J. R.
(1999). Intimal Tear Without Hematoma : An Important Variant of Aortic Dissection That Can Elude Current Imaging Techniques. Circulation
99: 1331-1336
[Abstract][Full Text]
Moriyama, Y., Yotsumoto, G., Kuriwaki, K., Watanabe, S., Hisatomi, K., Shimokawa, S., Toyohira, H., Taira, A.
(1998). Intramural hematoma of the thoracic aorta. Eur. J. Cardiothorac. Surg.
13: 230-239
[Abstract][Full Text]
Saku, K., Takeda, Y., Nii, T., Shirai, K., Okabe, M., Ohta, T., Arakawa, K., Saku, K.
(1997). Three-Dimensional Spiral Computed Tomography Angiography as an Alternative Imaging Modality for a Silent Dissecting Aortic Aneurysm: A Case Report. ANGIOLOGY
48: 1067-1071
[Abstract]
Harris, K. M., Braverman, A. C., Gutierrez, F. R., Barzilai, B., Davila-Roman, V. G.
(1997). TRANSESOPHAGEAL ECHOCARDIOGRAPHIC AND CLINICAL FEATURES OF AORTIC INTRAMURAL HEMATOMA. J. Thorac. Cardiovasc. Surg.
114: 619-626
[Abstract][Full Text]
Raymond, J. T., Skalina, S. M., Kerstein, M. D., Dupont, J.-R.
(1997). Infrarenal Abdominal Aortic Dissections: Case Reports. VASC ENDOVASCULAR SURG
31: 91-97
[Abstract]
Poppas, A., Sawyer, R., Kinder, C., Vignon, P., Bednarz, J., Lee, B. K., Feldman, T., Glagov, S., Lang, R. M.
(1996). A 73-Year-Old Man With Hypertension and Syncope. Circulation
93: 380-386
[Full Text]
Bogren, H. G., Lam, A. M., Enokawa, Y., Seko, Y., Yazaki, Y., Daniel, W. G., Mugge, A.
(1995). Transesophageal Echocardiography. NEJM
333: 1153-1154
[Full Text]
O'Gara, P. T., DeSanctis, R. W.
(1995). Acute Aortic Dissection and Its Variants : Toward a Common Diagnostic and Therapeutic Approach. Circulation
92: 1376-1378
[Full Text]
Nienaber, C. A., von Kodolitsch, Y., Petersen, B., Loose, R., Helmchen, U., Haverich, A., Spielmann, R. P.
(1995). Intramural Hemorrhage of the Thoracic Aorta : Diagnostic and Therapeutic Implications. Circulation
92: 1465-1472
[Abstract][Full Text]
Daniel, W. G., Mugge, A.
(1995). Transesophageal Echocardiography. NEJM
332: 1268-1280
[Full Text]
Banning, A. P, Ruttley, M. S T, Musumeci, F., Fraser, A. G
(1995). Acute dissection of the thoracic aorta. BMJ
310: 72-73
[Full Text]
Rizzo, R. J., Aranki, S. F., Aklog, L., Couper, G. S., Adams, D. H., Collins, J. J. Jr., Kinchla, N. M., Allred, E. N., Cohn, L. H.
(1994). Rapid noninvasive diagnosis and surgical repair of acute ascending aortic dissection: Improved survival with less angiography. J. Thorac. Cardiovasc. Surg.
108: 567-575
[Abstract][Full Text]
Blanchard, D. G., Kimura, B. J., Dittrich, H. C., DeMaria, A. N.
(1994). Transesophageal Echocardiography of the Aorta. JAMA
272: 546-551
[Abstract]
Hartnell, G., Costello, P., Goldstein, S. A., Lindsay, J., Vasan, R., Nienaber, C. A., Spielmann, R. P., Cigarroa, J. E., Eagle, K. A., Isselbacher, E. M.
(1993). The Diagnosis of Thoracic Aortic Dissection by Noninvasive Imaging Procedures. NEJM
328: 1637-1638
[Full Text]