Aortic Dissection

Hypertension should be treated with an infusion such as labetalol. Aortic regurgitation and pericardial effusion (haemopericardium) suggest dissection down to the aortic root. These features, or persisting chest pain suggest that the patient requires prompt surgery.

Aortic dissection can present with pain radiating to the epigastric region or back. If the dissection flap involves close to the aortic root, then the coronary flow can be affected, causing either inferior MI in right coronary artery or anterior MI in left anterior descending artery involvement. Cardiac tamponade can also be caused by dissection (blood flowing into pericardial space) and leading to a raised JVP and pulsus paradoxus.