How does this present clinically?
- Aortic dissection presents as a sudden severe chest pain, which is maximal at onset, radiating through to the back. Pain may radiate to arms, neck and abdomen.
- There may be signs of shock either from cardiac tamponade or from external rupture of the aneurysm.
- Less common presentations include progressive symptoms with loss of pulses as dissection also progresses. If renal vessels involved then may see haematuria or anuria. One or both femoral pulses may disappear and produce leg ischemia. Mesenteric ischaemia is usually late. Neurological abnormlaities may also occur ranging from hemiparesis (occlusion of carotid and subclavian artery origins) to paraesthesia (peripheral nerve ischaemia).
- It has a high mortality.