Pathogenesis of aortic dissection (illustration)

Case contributed by Vincent Tatco

This stack of images shows the formation of an aortic dissection. Aortic dissection starts from an intimal tear within the aorta which allows blood to enter and infiltrate into the media.  A false channel or lumen is created separating the intima from the rest of the aortic wall. The false lumen usually exhibits a higher pressure than the true lumen resulting to distal extension of the dissection and compression of the true lumen. The displaced intimal flap may cause obstruction of a branch vessel which may result to end-organ malperfusion. Sometimes dissection ruptures back through the endothelium forming a re-entry tear distally and this results to equalization of pressure and flow between the false and true aortic channels thereby decreasing the risk of end-organ malperfusion. 

Case Discussion

This diagram depicts the formation of an aortic dissection, which is one of the possible causes of an acute aortic syndrome.

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