Arterial dissection occurs when blood enters the media through a tear or ulcer in the intima and tracks along the media, forming a second blood-filled channel within the wall. The normal lumen lined by intima is called the true lumen and the blood-filled channel in the media is called the false lumen. The false lumen is at a higher pressure than the true lumen due to poor outflow.
In most cases the vessel wall is abnormal.
- hypertension 3 (pathogenesis: medial degeneration)
- inherited connective tissue disorders (pathogenesis: medial degeneration)
- atherosclerosis (pathogenesis: penetrating ulcer)
vasculitides (pathogenesis: inflammation)
- e.g. Behcet disease
- pregnancy (pathogenesis: unknown)
- iatrogenic: aortic cathterisation, intra-aortic balloon pump
- relapsing polychondritis (rare): pathogenesis?
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