Acute aortic syndrome

Acute aortic syndrome encompasses different forms of acute cardiovascular conditions, i.e. aortic dissection, intramural haematoma, limited intimal tear and penetrating aortic ulcerations, often leading to acute haemodynamic deterioration with circulatory shock and high mortality. Risk factors are hypertension, age, and genetic conditions leading to abnormal fibrillin proteins facilitating aortic wall pathologies. Type A dissection starts from the aortic root and extends to the ascending and often descending aorta, while Type B dissections starts in the descending artery and may develop distally down to the iliac or femoral arteries. Risk factors are genetic mutations of pertinent genes leading to Marfan’s syndrome and other connective tissue diseases, hypertension, and bicuspid aortic valves. The diagnosis involves primarily imaging with transoesophageal echocardiography, computer tomography, or magnetic resonance imaging. Therapeutically, Type A dissection is an absolute emergency and requires an immediate operative intervention. Type B dissection, on the other hand, is often treated conservatively with blood pressure control.