Core Keyword List, March 2017.Xlsx

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Vascular Medicine Core Keywords Disease States/Risk Factor Terms Therapeutic Terms Imaging/Diagnostic Terms abdominal aortic aneurysm (AAA) ablation angiography acute aortic syndrome amputation ankle-brachial index (ABI) acute limb ischemia (ALI) angioplasty brachial artery reactivity antiphospholipid antibody syndrome anticoagulation carotid intima medial thickness (CIMT) aortic disease (other) anti-hypertensive therapy computed tomographic angiography (CTA) aortic dissection anti-platelet therapy duplex ultrasound aortitis anti-thrombotic therapy echocardiography arterial aneurysm (not aortic) biological therapies flow mediated vasodilation arterial compression syndromes bypass functional assessment arterial dissection (not aortic) compression therapy intravascular ultrasound arterial thrombosis endarterectomy magnetic resonance angiography (MRA) autoimmune disease endovascular therapy magnetic resonance imaging (MRI) behcet syndrome exercise therapy point-of-care devices carotid artery disease interventional radiology positron emission tomography (PET) cerebrovascular disease, other other pharmacotherapy toe-brachial index (TBI) chronic kidney disease (CKD) radiation safety transcutaneous oximetry (Tcpo2) chronic venous disease revascularization vascular imaging claudication sclerotherapy vascular physiological testing coronary artery disease smoking cessation critical limb ischemia (CLI) statins Basic/Translational/Mechanistic Terms deep vein thrombosis (DVT) stem cell therapy aldosterone diabetes mellitus stent angiogenesis embolism thrombectomy animal model fibromuscular dysplasia (FMD) thrombolytic therapy arterial stiffness hypercoagulable states vascular medicine asymmetric dimethylarginine (ADMA) hyperlipidemia vascular surgery atherosclerosis hypertension vena cava filter biomarkers lipedema wound care bleeding lower extremity wound (ulcer) calcification lymphedema Study Type/Miscellaneous Terms coagulation mesenteric artery disease accreditation cytokines obesity aging endothelial function occupational vascular disorders certification endothelial progenitor cells other peripheral vascular disorder children exome sequencing peripheral artery disease (PAD) comparative effectiveness family history post-thrombotic syndrome disease prevention hypoxia pulmonary embolism (PE) economic anaysis infection pulmonary hypertension epidemiology inflammation Raynaud's phenomenon ethics insulin resistance renal artery disease genetics ischemia risk factors implementation science lipids sedentary lifestyle medical education lipoprotein (a) smoking meta-analysis metabolomics stroke patient centered microcirculation superficial vein thrombophlebitis (SVT) patient education nitric oxide (NO) thoracic aortic aneurysm physiology nutrition thoracic outlet syndrome (TOS) population health oxidative stress thoracoabdominal aneurysm practice guidelines pharmacogenomics thromboangiitis obliterans quality improvement physical actvity thrombophilia qualty of life platelets upper extremity disorders, other racial disparities renin-angiotensin system varicose veins randomized controlled trial (RCT) thrombosis vascular complications registries vascular endothelium vascular malformation risk stratification vasculogenesis vascular trauma screening vasospasm vasculitis sex differences venous insufficiency simulation venous thromboembolism (VTE) surveys vascular biology.

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Clinical Characteristics in STEMI-Like Aortic Dissection Versus STEMI-Like Pulmonary Embolism
A V ARCHIVES OF M VASCULAR MEDICINE Research Article More Information *Address for Correspondence: Oscar MP Clinical characteristics in STEMI- Jolobe, MRCP, Manchester Medical Society, Medical Division, Simon Building, Brunswick Street, Manchester, M13 9PL, UK, like aortic dissection versus Tel: 44 161 900 6887; Email: oscarjolobe@yahoo.co.uk STEMI-like pulmonary embolism Submitted: 07 July 2020 Approved: 30 July 2020 Published: 31 July 2020 Oscar MP Jolobe* How to cite this article: Jolobe OPM. Clinical Manchester Medical Society, Medical Division, Simon Building, Brunswick Street, Manchester, characteristics in STEMI-like aortic dissection M13 9PL, UK versus STEMI-like pulmonary embolism. Arch Vas Med. 2020; 4: 019-030. DOI: 10.29328/journal.avm.1001013 Abstract Copyright: © 2020 Jolobe OPM. This is an open access article distributed under the Creative Dissecting aortic aneurysm with ST segment elevation, and pulmonary embolism with ST segment Commons Attribution License, which permits elevation are two of a number of clinical entities which can simulate ST segment elevation myocardial infarction. unrestricted use, distribution, and reproduction in any medium, provided the original work is Objective: The purpose of this review is to analyse clinical features in anecdotal reports of 138 dissecting properly cited. aortic aneurysm patients with STEMI-like presentation, and 102 pulmonary embolism patients with STEMI-like presentation in order to generate insights which might help to optimise triage of patients with STEMI-like clinical Keywords: Aortic dissection; Pulmonary presentation. embolism; ST-elevation; Percutaneous coronary intervention Methods: Reports were culled from a literature search covering the period January 2000 to March 2020 using Googlescholar, Pubmed, EMBASE and MEDLINE.
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Diagnostic Test Accuracy of D-Dimer for Acute Aortic Syndrome
www.nature.com/scientificreports OPEN Diagnostic test accuracy of D-dimer for acute aortic syndrome: systematic review and meta- Received: 06 April 2016 Accepted: 10 May 2016 analysis of 22 studies with 5000 Published: 27 May 2016 subjects Hiroki Watanabe1, Nobuyuki Horita1, Yuji Shibata1, Shintaro Minegishi2, Erika Ota3 & Takeshi Kaneko1 Diagnostic test accuracy of D-dimer for acute aortic dissection (AAD) has not been evaluated by meta- analysis with the bivariate model methodology. Four databases were electrically searched. We included both case-control and cohort studies that could provide sufficient data concerning both sensitivity and specificity of D-dimer for AAD. Non-English language articles and conference abstract were allowed. Intramural hematoma and penetrating aortic ulcer were regarded as AAD. Based on 22 eligible articles consisting of 1140 AAD subjects and 3860 non-AAD subjects, the diagnostic odds ratio was 28.5 (95% CI 17.6–46.3, I2 = 17.4%) and the area under curve was 0.946 (95% CI 0.903–0.994). Based on 833 AAD subjects and 1994 non-AAD subjects constituting 12 studies that used the cutoff value of 500 ng/ ml, the sensitivity was 0.952 (95% CI 0.901–0.978), the specificity was 0.604 (95% CI 0.485–0.712), positive likelihood ratio was 2.4 (95% CI 1.8–3.3), and negative likelihood ratio was 0.079 (95% CI 0.036–0.172). Sensitivity analysis using data of three high-quality studies almost replicated these results. In conclusion, D-dimer has very good overall accuracy. D-dimer <500 ng/ml largely decreases the possibility of AAD.
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Acute Chest Pain-Suspected Aortic Dissection
Revised 2021 American College of Radiology ACR Appropriateness Criteria® Suspected Acute Aortic Syndrome Variant 1: Acute chest pain; suspected acute aortic syndrome. Procedure Appropriateness Category Relative Radiation Level US echocardiography transesophageal Usually Appropriate O Radiography chest Usually Appropriate ☢ MRA chest abdomen pelvis without and with Usually Appropriate IV contrast O MRA chest without and with IV contrast Usually Appropriate O CT chest with IV contrast Usually Appropriate ☢☢☢ CT chest without and with IV contrast Usually Appropriate ☢☢☢ CTA chest with IV contrast Usually Appropriate ☢☢☢ CTA chest abdomen pelvis with IV contrast Usually Appropriate ☢☢☢☢☢ US echocardiography transthoracic resting May Be Appropriate O Aortography chest May Be Appropriate ☢☢☢ MRA chest abdomen pelvis without IV May Be Appropriate contrast O MRA chest without IV contrast May Be Appropriate O MRI chest abdomen pelvis without IV May Be Appropriate contrast O CT chest without IV contrast May Be Appropriate ☢☢☢ CTA coronary arteries with IV contrast May Be Appropriate ☢☢☢ MRI chest abdomen pelvis without and with Usually Not Appropriate IV contrast O ACR Appropriateness Criteria® 1 Suspected Acute Aortic Syndrome SUSPECTED ACUTE AORTIC SYNDROME Expert Panel on Cardiac Imaging: Gregory A. Kicska, MD, PhDa; Lynne M. Hurwitz Koweek, MDb; Brian B. Ghoshhajra, MD, MBAc; Garth M. Beache, MDd; Richard K.J. Brown, MDe; Andrew M. Davis, MD, MPHf; Joe Y. Hsu, MDg; Faisal Khosa, MD, MBAh; Seth J. Kligerman, MDi; Diana Litmanovich, MDj; Bruce M. Lo, MD, RDMS, MBAk; Christopher D. Maroules, MDl; Nandini M. Meyersohn, MDm; Saurabh Rajpal, MDn; Todd C. Villines, MDo; Samuel Wann, MDp; Suhny Abbara, MD.q Summary of Literature Review Introduction/Background Acute aortic syndrome (AAS) includes the entities of acute aortic dissection (AD), intramural hematoma (IMH), and penetrating atherosclerotic ulcer (PAU).
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Current Options and Recommendations for the Treatment of Thoracic Aortic Pathologies Involving the Aortic
Eur J Vasc Endovasc Surg (2019) 57, 165e198 Editor’s Choice e Current Options and Recommendations for the Treatment of Thoracic Aortic Pathologies Involving the Aortic Arch: An Expert Consensus Document of the European Association for Cardio-Thoracic Surgery (EACTS) & the European Society for Vascular Surgery (ESVS) Martin Czerny a,*, Jürg Schmidli a, Sabine Adler a, Jos C. van den Berg a, Luca Bertoglio a, Thierry Carrel a, Roberto Chiesa a, Rachel E. Clough a, Balthasar Eberle a, Christian Etz a, Martin Grabenwöger a, Stephan Haulon a, Heinz Jakob a, Fabian A. Kari a, Carlos A. Mestres a, Davide Pacini a, Timothy Resch a, Bartosz Rylski a, Florian Schoenhoff a, Malakh Shrestha a, Hendrik von Tengg-Kobligk a, Konstantinos Tsagakis a, Thomas R. Wyss a Document Reviewers b, Nabil Chakfe, Sebastian Debus, Gert J. de Borst, Roberto Di Bartolomeo, Jes S. Lindholt, Wei-Guo Ma, Piotr Suwalski, Frank Vermassen, Alexander Wahba, Moritz C. Wyler von Ballmoos Keywords: Expert consensus document, Aortic arch, Open repair, Endovascular repair TABLE OF CONTENTS Abbreviations and acronyms ...................................................................................... 166 1. Introduction ........................................................ .................................................167 1.1. Purpose ....................................................... ................................................167 1.2. Classes of recommendations and levels of evidence ........................................................................167
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Aortic Diseases Esc Guidelines on the Diagnosis and Treatment of Aortic Diseases
ESSENTIAL MESSAGES FROM ESC GUIDELINES Committee for Practice Guidelines To improve the quality of clinical practice and patient care in Europe AORTIC DISEASES ESC GUIDELINES ON THE DIAGNOSIS AND TREATMENT OF AORTIC DISEASES For more information www.escardio.org/guidelines 2014 ESC GUIDELINES ON THE DIAGNOSIS AND TREATMENT OF AORTIC DISEASES* The Task Force on diagnosis and treatment of aortic diseases of the European Society of Cardiology (ESC) Chairpersons Raimund Erbel Victor Aboyans Department of Cardiology Department of Cardiology West-German Heart Center Dupuytren University Hospital University Duisburg-Essen 2. Avenue Martin Luther King Hufelandstr 55 87042 Limoges, France DE-45122 Essen, Germany Tel. +33 5 55 05 63 10 Tel.: 49 201 723 4801 Fax +33 5 55 05 63 84 Fax: 49 201 723 5401 Email: victor.aboyans@chu-limoges.fr Email: erbel@uk-essen.de Authors/Task Force Members Catherine Boileau (France), Eduardo Bossone (Italy), Roberto Di Bartolomeo (Italy), Holger Eggebrecht (Germany), Arturo Evangelista (Spain), Volkmar Falk (Switzerland), Herbert Frank (Austria), Oliver Gaemperli (Switzerland), Martin Grabenwöger (Austria), Axel Haverich (Germany), Bernard Iung (France), Athanasios John Manolis (Greece), Folkert Meijboom (Netherlands), Christophe A. Nienaber (Germany), Marco Roffi (Switzerland), Hervé Rousseau (France), Udo Sechtem (Germany), Per Anton Sirnes (Norway), Regula S. von Allmen (Switzerland), Christiaan J.M. Vrints (Belgium). Other ESC entities having participated in the development of this document: ESC Associations: Acute Cardiovascular Care Association (ACCA), European Association of Cardiovascular Imaging (EACVI), European Association of Percutaneous Cardiovascular Interventions (EAPCI). ESC Council: Council for Cardiology Practice (CCP). ESC Working Groups: Cardiovascular Magnetic Resonance, Cardiovascular Surgery, Grown-up Congenital Heart Disease, Hypertension and the Heart, Nuclear Cardiology ESC Staff: Veronica Dean, Catherine Despres, Myriam Lafay, Sophia Antipolis, France Special thanks to Jose Luis Zamorano, Jeroen J.
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Appendix A: Doppler Ultrasound and Ankle–Brachial Pressure Index
Appendix A: Doppler Ultrasound and Ankle–Brachial Pressure Index Camila Silva Coradi, Carolina Dutra Queiroz Flumignan, Renato Laks, Ronald Luiz Gomes Flumignan, and Bruno Henrique Alvarenga Abstract The ankle–brachial index is one of the simplest, costless, and with utmost importance tool for the diagnosis, screening, and segment of peripheral arterial disease and we need to know how to use it. The simplicity of the examination with Doppler ultrasound is undoubtedly the factor that most contributes to the adoption of this device as vascular preliminary tool. As a blood velocity detec- tor, Doppler ultrasound can be used to determine the systolic pressure of the arteries, which are the targets of the study. In this case, a sphygmomanometer is also required. They will be used in determined limb segments (upper and lower limbs) to temporarily occlude the blood flow and consequently assess the related blood pressure. The normal value of the index is 0.9–1.1. Values less than 0.9 indicate peripheral arterial disease and it is correlated with increased risk of future cardiac events. The index can be related with symptoms accord- ing to its value. When the ABI falls to 0.7–0.8 it is associated with lameness, 0.4–0.5 indicates pain, and 0.2–0.3 is typically associated with gangrene and nonhealing ulcers. Doppler Ultrasound The Austrian physicist Johann Christian Andreas Doppler (1803–1853) observing the different colorations that certain stars had questioned why this phenomenon. In 1842, he discovered the modifying effect of the vibration frequency caused by the relative movement between the source and the observer.
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Core Keyword List
Vascular Medicine Core Keywords Disease States/Risk Factor Terms Therapeutic Terms Imaging/Diagnostic Terms abdominal aortic aneurysm (AAA) ablation angiography acute aortic syndrome amputation ankle-brachial index (ABI) acute limb ischemia (ALI) angioplasty brachial artery reactivity aneurysm anticoagulation carotid intima medial thickness (CIMT) antiphospholipid antibody syndrome (APLA) anti-hypertensive therapy computed tomography (CT) aortic disease anti-platelet therapy CT angiography (CTA) aortic dissection anti-thrombotic therapy duplex ultrasound aortitis biological therapies echocardiography arterial aneurysm bypass flow mediated vasodilation arterial compression syndromes compression therapy functional assessment arterial dissection endarterectomy intravascular ultrasound arterial thrombosis endovascular therapy magnetic resonance angiography (MRA) autoimmune disease exercise therapy magnetic resonance imaging (MRI) carotid artery disease interventional radiology point-of-care devices cardiovascular disease pharmacotherapy positron emission tomography (PET) cerebrovascular disease radiation safety toe-brachial index (TBI) chronic kidney disease (CKD) revascularization transcutaneous oximetry (Tcpo2) chronic venous disease sclerotherapy vascular imaging/diagnostics claudication smoking cessation vascular physiological testing coronary artery disease statins critical limb ischemia (CLI) stem cell therapy Basic/Translational/Mechanistic Terms deep vein thrombosis (DVT) stent aldosterone diabetes mellitus thrombectomy angiogenesis
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Acute Aortic Syndrome
Keynote Lecture Series Acute aortic syndrome Joel S. Corvera Division of Cardiothoracic Surgery, Indiana University School of Medicine and Indiana University Health, Indianapolis, IN, USA Correspondence to: Joel S. Corvera, MD, FACS. Assistant Professor of Surgery, Indiana University School of Medicine, Director of Thoracic Vascular Surgery, Indiana University Health, 1801 N. Senate Boulevard, Suite 3300, Indianapolis, IN 46202, USA. Email: jcorvera@iuhealth.org. Acute aortic syndrome (AAS) is a term used to describe a constellation of life-threatening aortic diseases that have similar presentation, but appear to have distinct demographic, clinical, pathological and survival characteristics. Many believe that the three major entities that comprise AAS: aortic dissection (AD), intramural hematoma (IMH) and penetrating aortic ulcer (PAU), make up a spectrum of aortic disease in which one entity may evolve into or coexist with another. Much of the confusion in accurately classifying an AAS is that they present with similar symptoms: typically acute onset of severe chest or back pain, and may have similar radiographic features, since the disease entities all involve injury or disruption of the medial layer of the aortic wall. The accurate diagnosis of an AAS is often made at operation. This manuscript will attempt to clarify the similarities and differences between AD, IMH and PAU of the ascending aorta and describe the challenges in distinguishing them from one another. Keywords: Acute aortic syndrome (AAS); aortic dissection (AD); intramural hematoma (IMH); penetrating aortic ulcer (PAU) Submitted Jan 12, 2016. Accepted for publication Apr 12, 2016. doi: 10.21037/acs.2016.04.05 View this article at: http://dx.doi.org/10.21037/acs.2016.04.05 Introduction Aortic dissection (AD) Acute aortic syndrome (AAS) is a term used to describe a Acute AD was first described by Morgagni in 1761 after the constellation of life-threatening aortic diseases that have death of King George II of Great Britain (2).
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Acute Aortic Syndromes
Acute Aortic Syndromes Vera H. Rigolin, MD, FASE, FACC, FAHA Professor of Medicine Northwestern University Feinberg School of Medicine Medical Director, Echocardiography Laboratory Northwestern Memorial Hospital Immediate Past-President, American Society of Echocardiography Disclosures Disclosures: None that pertain to this presentation. Acute Aortic Syndrome • Aortic dissection • Intramural hematoma • Atherosclerotic plaque rupture • Penetrating ulcer • Aneurysm rupture All have similar clinical presentations Sudden onset severe chest/back pain Aortic Dissection • Annual incidence is 10-30 per million • Usually occurs in pts with pre-existing aortic conditions – Aneurysms, Marfan’s, bicuspid AV, HTN • Intimal tear into media. Column of blood propagates prox and distal to tear. Types of Aortic Dissection Feigenbaum’s Echocardiography, 7th ed. 2010 Complications of Aortic Dissection • Pericardial effusion • Complete or partial aortic rupture • Compromise of branch vessels • Coronary artery compromise • Aortic pseudoaneurysm • Aortic insufficiency History • 52 yo M w/ HTN, HL presented with chest pressure and headache. • Chest pressure began after pt began after a migraine. • Describes chest sensation as constant "pressure" in substernal, as if "someone were pressing on my chest”. • Chest pressure was constant, lasted until pt received SLNG in ED. • In ED, noted new heart murmur. EKG was non-ischemic. CXR negative for acute process. Trop=0.02 • Echo with Doppler/stress echo ordered PLAX PLAX PLAX Suprasternal Notch Apical 5 Chamber Spectral Doppler Intra-op TEE Mechanisms of AR in Aortic Dissection Feigenbaum’s Echocardiography, 7th ed. 2010 65 yr old Asian Female Complaining of Chest Pain M-mode AV PLAX Accuracy of TEE for Diagnosis of Aortic Dissection Feigenbaum’s Echocardiography, 7th ed. 2010 Intramural Hematoma • Variant of aortic dissection • Hemorrhage into media without rupture into lumen • Defined as area of crescenteric thickening of wall of >7 mm.
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Acute Aortic Dissection and Intramural Hematoma a Systematic Review
Clinical Review & Education JAMA | Review Acute Aortic Dissection and Intramural Hematoma A Systematic Review Firas F. Mussa, MD; Joshua D. Horton, MD; Rameen Moridzadeh, MD; Joseph Nicholson, PhD; Santi Trimarchi, MD, PhD; Kim A. Eagle, MD Supplemental content at IMPORTANCE Acute aortic syndrome (AAS), a potentially fatal pathologic process within the jama.com aortic wall, should be suspected in patients presenting with severe thoracic pain and CME Quiz at hypertension. AAS, including aortic dissection (approximately 90% of cases) and intramural jamanetworkcme.com and hematoma, may be complicated by poor perfusion, aneurysm, or uncontrollable pain and CME Questions page 768 hypertension. AAS is uncommon (approximately 3.5-6.0 per 100 000 patient-years) but rapid diagnosis is imperative as an emergency surgical procedure is frequently necessary. OBJECTIVE To systematically review the current evidence on diagnosis and treatment of AAS. EVIDENCE REVIEW Searches of MEDLINE, EMBASE, and the Cochrane Register of Controlled Trials for articles on diagnosis and treatment of AAS from June 1994 to January 29, 2016, were performed. Only clinical trials and prospective observational studies of 10 or more patients were included. Eighty-two studies (2 randomized clinical trials and 80 observational) describing 57 311 patients were reviewed. FINDINGS Chest or back pain was the most commonly reported presenting symptom of AAS (61.6%-84.8%). Patients were typically aged 60 to 70 years, male (50%-81%), and had hypertension (45%-100%). Sensitivities of computerized tomography and magnetic resonance imaging for diagnosis of AAS were 100% and 95% to 100%, respectively. Transesophageal echocardiography was 86% to 100% sensitive, whereas D-dimer was 51.7% to 100% sensitive and 32.8% to 89.2% specific among 6 studies (n = 876).
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Acute Vascular Syndromes
7 CHAPTER 7 ACUTE VASCULAR SYNDROMES 7.1 ACUTE AORTIC SYNDROMES ______________________________________________ p.92 A. Evangelista 7.2 ACUTE PULMONARY EMBOLISM __________________________________________ p.102 A. Torbicki ACUTE AORTIC SYNDROMES: Concept and classification (1) Types of presentation 7.1 P.92 Classic aortic dissection Separation of the aorta media with presence of extraluminal blood within the layers of the aortic wall. The intimal flap divides the aorta into two lumina, the true and the false Intramural hematoma (IMH) Aortic wall hematoma with no entry tear and no two-lumen flow Penetrating aortic ulcer (PAU) Atherosclerotic lesion penetrates the internal elastic lamina of the aorta wall Aortic aneurysm rupture (contained or not contained) ACUTE AORTIC SYNDROMES: Concept and classification (2) Anatomic classification and time course 7.1 P.93 DeBakey’s Classification • Type I and Type II dissections both originate in the ascending aorta In type I, the dissection extends distally to the descending aorta In type II, it is confined to the ascending aorta • Type III dissections originate in the descending aorta Stanford Classification De Bakey Type I Type II Type III • Type A includes all dissections involving the ascending aorta regardless of entry site location • Type B dissections include all those distal to the brachiocephalic trunk, sparing the ascending aorta Time course • Acute: <14 days • Subacute: 15-90 days • Chronic: >90 days Stanford Type A Type A Type B Adapted with permission from Nienaber CA, Eagle KA, Circulation 2003;108(6):772-778. All rights reserved. Copyright: Nienaber CA, Eagle KA. Aortic dissection: new frontiers in diagnosis and management: Part II: therapeutic management and follow-up.
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Acute Aortic Syndrome
ACUTE AORTIC SYNDROME AAMIR SUHAIL MD DALHOUSIE UNIVERSITY ACUTE AORTIC SYNDROME • Heterogeneous group of patients with a similar clinical profile . • Non-traumatic life threatening injuries of the thoracic aorta. • Aortic Dissection • Intramural Hematoma (IMH) • Penetrating Atherosclerotic Ulcer (PAU) • Overall incidence is 2.6 – 3.5 cases / 100,000 person years. • Approx 65% of patients are men • Average at of presentation is 65 Abbas, A., I. Brown W., C. Peebles R., S. Harden P., and J. Shambrook S. "The Role of Multidetector-row CT in the Diagnosis, Classification and Management of Acute Aortic Syndrome." The British Journal of Radiology BJR 87.1042 (2014): 20140354. Web. RISK FACTORS • Hypertension (~72%) • Genetic • Marfan’s Sx (70%), Loeys-Dietz sx (32%), Ehlers-Danlos sx, Turner • Bicuspid Aortic Valve (2-9% of Type A, 3% of Type b) • HAS. • Mutations that affect structural proteins at the interface between ECM and smooth muscle cells • Influence aortic response to mechanical stimuli • Inflammatory Vascular Disease • Syphillis, Behcet’s, Takayasu arteritis, GCA • Iatrogenic • Aortic catheterization, Cardiac valve or Aortic Surgery Abbas, A., I. Brown W., C. Peebles R., S. Harden P., and J. Shambrook S. "The Role of Multidetector-row CT in the Diagnosis, Classification and Management of Acute Aortic Syndrome." The British Journal of Radiology BJR 87.1042 (2014): 20140354. Web. CLINICAL PRESENTATION • Severe tearing chest pain • 84-90% of cases • Maximal intensity at the time of onset • Acute Coronary Syndrome (ACS) – gradual increase in intensity. • Radiating to the neck, jaw or throat • Involvement of ascending aorta • Referred pain to the back or abdomen • Descending aorta • Other • Pulse deficits, regurgitant aortic murmur • Syncope • Heralds rupture or cerebrovascular occlusion Abbas, A., I.
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