Abstract
Background : Acute aortic syndrome (AAS) is a potentially fatal disease involving the acute disruption of the aortic wall. Several conditions, such as intramural hematoma (IMH), aortic dissection (AD), penetrating atherosclerotic ulcer (PAU), as well as high mortality rates, are associated with this disease. Hypertension is an essential risk factor, and patients often present with pain. AAS may be challenging to be evaluated, as it has a pre-test probability and several diagnostic tests. Objective : This literature review will discuss the proper diagnosis and management of Acute aortic Syndrome patients. Discussion : Computed Tomography Angiography (CTA) is essential in managing AAS. The significance of prompt diagnosis and treatment of AAS is emphasized further by the current developments in imaging techniques and therapeutic interventions, ultimately leading to increased vigilance of this disease. Management of AAS included initial medical therapy and definitive therapy. Conclusion : In A type AAS, surgical intervention is the definitive therapy, while type B is managed definitively by endovascular or medical treatment
Highlights
One of the most perilous emergencies in cardiology is acute aortic syndrome (AAS), which is defined as acute disruption of the aortic wall.[1,2] Several conditions, such as intramural hematoma (IMH), aortic dissection (AD), penetrating atherosclerotic ulcer (PAU), as well as high mortality rates, are associated with this disease.[2]
31% of patients had a history of atherosclerosis, and correlation with Marfan’s syndrome and iatrogenic causes were found in several patients (5% and 4%, respectively).[2]
The crescentic or circular highly-attenuated area on Computed Tomography (CT), which did not enhance after contrast medium injection, is diagnostic for IMH 7 Contrast-filled pouch-like protrusion in the thickened aortic wall is the typical finding for PAU in an atherosclerotic process
Summary
One of the most perilous emergencies in cardiology is acute aortic syndrome (AAS), which is defined as acute disruption of the aortic wall.[1,2] Several conditions, such as intramural hematoma (IMH), aortic dissection (AD), penetrating atherosclerotic ulcer (PAU), as well as high mortality rates, are associated with this disease.[2]. There are several predisposing factors of aortic dissection, with hypertension being the most prevalent (72%). 31% of patients had a history of atherosclerosis, and correlation with Marfan’s syndrome and iatrogenic causes were found in several patients (5% and 4%, respectively).[2] The risk factors for IMH and PAU was hypertension, hypercholesterolemia, and smoking.[7] The significance of prompt diagnosis and treatment of AAS is emphasized further by the current developments in imaging techniques and therapeutic interventions, leading to increased vigilance of this disease.[8,9] Corroboration of clinical suspicion, localization of tears, classification, and determination of urgency and the extent of dissection are the primary goals of diagnostic imaging studies upon clinical suspicion of AAS.[8]
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