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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
