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How do you manage Type B dissection?

How do you manage Type B dissection?

Uncomplicated type B aortic dissection is generally managed with optimal medical therapy, which includes pain control and strict blood pressure and heart rate control (also referred to as “anti-impulse therapy”) [1].

How do you medically manage an aortic dissection?

Treatment for type A aortic dissection may include:

  1. Surgery. Surgeons remove as much of the dissected aorta as possible and stop blood from leaking into the aortic wall.
  2. Medications. Medications are given to reduce heart rate and lower blood pressure, which can prevent the aortic dissection from worsening.

What medications treat aortic dissection?

Beta Blockers and Other Antihypertensive Medications Beta blockers are often the first treatment for a type B aortic dissection. These medications reduce blood pressure by blocking the effects of the hormone epinephrine, or adrenaline. This relaxes the heart, slowing it down.

Can aortic dissection be treated with medication?

Aortic dissection is typically treated using either medication or through surgery.

Does Type B aortic dissection require surgery?

The primary treatment of uncomplicated acute type B aortic dissection remains medical [3,4], derived from the early experience in the 1960s that suggested better outcomes with medical management compared with surgery [5,6].

Why is labetalol used in aortic dissection?

Hypertension in suspected or proven aortic dissection must be aggressively treated with intravenous labetalol using invasive arterial monitoring to reduce the progression of the dissection process (Grade D)The use of only a vasodilator or a -blocker can accentuate the dissection.

What is type B aortic dissection?

Aortic dissections are classified into two types: type B dissection involves a tear in the descending part of the aorta and may extend into the abdomen, whereas type A dissection develops in the ascending part of the aorta just as it branches off the heart.

Which beta blocker is best for aortic dissection?

Intravenous propranolol, metoprolol, labetalol, or esmolol are suggested as excellent choices for initial treatment. In patients who are unable to tolerate beta-blockade, non-dihydropyridine calcium channel antagonists (verapamil, diltiazem) were suggested to offer acceptable, although less-established, alternatives.

Can a Type B aortic dissection heal?

Conclusions. Patients aged 80 years and older who underwent medical treatment for acute and subacute type B dissection had excellent outcomes in chronic phase. The elderly patients had less surgical intervention, but aortic related death did not differ from younger patients.

How long can you live with aortic dissection B?

Short- and long-term prognosis after discharge from the hospital for acute type B dissection remains unclear. Previous studies are inconsistent and have reported survival rates between 56% and 92% at 1 year and 48% to 82% at 5 years.

Why is hydralazine contraindicated in aortic dissection?

Hydralazine and sodium nitroprusside have been used in the past for medical management of type B AAD. Although these agents reduce blood pressure, they increase the maximal force of left ventricular contraction dP/dtmax) and cause reflex tachycardia and are, thus, contraindicated in patients with AAD.

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