Amanda F.

asked • 02/22/21

Pathophysiology: Aortic Dissection vs. Thoracic Aortic Aneurysm

A 55-year-old man presents at the emergency department of his local hospital with complaints of excruciating, “ripping” pain in his upper back. He has a history of poorly controlled hypertension. His radial pulse and blood pressure, which on admission were 92 and 140/80mmHg, respectively, become unobtainable in both arms. A transesophageal echocardiogram reveals a dissection of the descending aorta. Aggressive blood pressure control is initiated with the goal of reducing the systolic pressure and pulse pressure.  

  1. Explain the consequence of poorly controlled blood pressure as an etiological factor in this man’s case.  
  2. Why did this patient’s radial pulse and blood pressure become unobtainable? 
  3. Explain the need for aggressive control of the aortic pressure and pulsatile blood flow (pulse pressure). 

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