Acute aortic syndrome
Acute aortic syndrome (AAS) describes a range of severe, painful, potentially life-threatening abnormalities of the aorta. These include aortic dissection, intramural thrombus, and penetrating atherosclerotic aortic ulcer. AAS can be caused by a lesion on the wall of the aorta that involves the tunica media, often in the descending aorta. It is possible for AAS to lead to acute coronary syndrome. The term was introduced in 2001. Signs and symptoms The most common symptom of AAS is sudden and severe chest pain. However, other variants of chest pain and back pain have been described. Causes Causes can include aortic dissection (which is the most common type), intramural hematoma, penetrating atherosclerotic ulcer or a thoracic aneurysm that has become unstable. The potential causes of AAS are life-threatening and present with similar symptoms, making it difficult to distinguish the ultimate cause, though high resolution, high contrast computerised tomography can be used. Diagnosis The condition can be mimicked by a ruptured cyst of the pericardium, ruptured aortic aneurysm and acute coronary syndrome. Misdiagnosis is estimated at 39% and is associated with delays correct diagnosis and improper treatment with anticoagulants producing excessive bleeding and extended hospital stays. Management AAS is life-threatening, with a high