Type A Aortic dissection

79 year old male with a past medical history significant for hypertension and diabetes presented with a sharp stabbing pain in his mid-chest and back.
CT angiography of his chest revealed type A aortic dissection (involving ascending aorta – see image above with arrow pointing to the intimal flap)

Classification
Aortic dissection is being classified into types A and B depending on the site of origin. Type A dissection involves ascending aorta. Type B begins in the descending part of the aorta.

Treatment
Type A dissection is considered to be a surgical emergency and should be treated surgically. The complications of the type A dissection include aortic regurgitation, myocardial infarction and cardiac tamponade.

Type B aortic dissection is generally being treated medically. Blood pressure and pain control are the main goals of the therapy. Intravenous B-blockers are the preferred agents for blood pressure control in these patients.

Outcomes
The outcomes for both types of dissection are generally good with appropriate therapy.
The patient above underwent a surgical repair of the dissection with an uneventful recovery.