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Aortic Dissections - #PHARMFAX

Updated: Jul 24, 2023

Aortic dissections is a tear of the inner aortic wall that creates a “false lumen” and can potentially rupture.


 


Aortic dissections is a tear of the inner aortic wall that creates a “false lumen” and can potentially rupture. Type A (associated with ascending aorta) are surgically treated, and Type B, the descending aorta, can be medically managed. Complications arise from impaired blood flow to vital organs and spread of the dissection to local arteries. Patients typically present with an abrupt tearing pain in the chest, back, or abdomen. Each patient should be evaluated by a cardiothoracic surgeon. Those who are uncomplicated or non-surgical candidates, the target for medical management is preventing rupture and propagation of dissection. That would be bad. Goals of medical management are a HR of around 60bpm and BP of 100-120. Avoid overshooting as this increases hypoperfusion and mortality. Beta-blockers are preferred. Esmolol, as a rapid acting B1 blocker, provides titratable kinetics making it ideal. Calcium channel blockers are alternatives. If additional BP lowering is required, antihypertensives with afterload reduction should be considered. Beta-blockade must be achieved prior to administering vasodilaters due to concerns for reflex tachycardia. Sodium nitroprusside and clevidipine are both rapid acting and have a short duration. Caution with cyanide toxicity with sodium nitroprusside. We don’t want more problems. Did you share the #PHARMFAX? Hit the like and follow button for more, and I hope you learned something new. Recommended Read/Watch ST Elevation Myocardial Infarction: https://www.instagram.com/reel/Csquz1hJUXw/ Massive Pulmonary Embolism: https://www.instagram.com/reel/CsnGYaYgCgx/ The ALL PHARMWYZE SOURCE (including references) | www.pharmwyze.com #aorticdissection #clevidipine #sodiumnitroprusside #esmolol #foamed #pharmacist #pharmwyze #pharmfax #criticalcare #emergencymedicine #studentpharmacist #nursingstudent #medicalstudent #pharmacy #medicine #nursing #meded

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