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Diagnosis and Management of Aortic Disease

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59 7. Acute Aortic Syndromes Table 22. Signs and Symptoms of AAS Clinical Signs and Symptoms Cause Asymmetric blood pressure (>20 mm Hg ) between limbs Compromise of branch artery flow Bowel ischemia or gastrointestinal bleed Malperfusion of the celiac or superior mesenteric artery Dysphagia Compression of the esophagus Dyspnea Compression of trachea or bronchus, congestive heart failure from aortic regurgitation, or cardiac tamponade Hemoptysis Vascular rupture into lung parenchyma Hoarseness Compression recurrent laryngeal nerve Horner's syndrome Compression of sympathetic chain Myocardial ischemia or myocardial infarction Coronary artery involvement by dissection or compression by aneurysm New murmur of aortic regurgitation Incomplete aortic valve closure secondary to leaflet tethering by the dilated aorta or cusp prolapse because of dissection into the aortic root Oliguria or hematuria (gross) Malperfusion of one or both renal arteries Paraplegia Spinal malperfusion attributable intercostal artery involvement Lower extremity ischemia Malperfusion of iliac artery Shock Cardiac tamponade, hemothorax, frank aortic rupture, acute severe aortic regurgitation, severe myocardial ischemia Shortness of breath Pericardial effusion, congestive heart failure from acute severe aortic regurgitation, or hemothorax Stroke symptoms Carotid or vertebral artery involved Superior vena cava syndrome Compression of the superior vena cava Syncope Carotid artery involvement or cardiac tamponade

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