|Aortic dissection is a former featured article candidate. Please view the links under Article milestones below to see why the nomination failed. For older candidates, please check the archive.|
|Current status: Former featured article candidate|
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|WikiProject Medicine / Cardiology||(Rated B-class, Mid-importance)|
|To-do list for Aortic dissection:|
- 1 Aortic aneurysm
- 2 Cleanup request
- 3 FAC
- 4 Genetic predisposition?
- 5 Partial thrombosis
- 6 Transthoracic Echo could be listed a valid Diagnostic Modality
- 7 Lancet
- 8 >6cm needing emergency surgery
- 9 Uploaded a new image
- 10 Traffic
- 11 Risk scoring
- 12 Diagnostic review
- 13 Plans for update
- 14 Sources
- 15 D-dimer
Care needs to be taken not to duplicate. Dissection I take to mean the splitting of layer of a blood vessel, vs aneurysm to be a stretched dilatation. An aneurysm may go on to dissect or rupture. This is a really comprehensive article, well done, and great care needs be taken in how we move any information over to Aortic Aneurysm. (merging into one article will be too long, but splitting risk duplication or incomplete discussion in any one article). David Ruben 20:19, 15 August 2005 (UTC)
- Not a lot of information should go from here to aortic aneurysm. Most aortic dissections do not start from aortic aneurysms so the two articles are about different subjects and should remain separate. Alex.tan 14:35, August 17, 2005 (UTC)
This article is full of medical jargon. It needs to be made more accessible to the general reader. -- Beland 03:00, 17 August 2005 (UTC)
I disagree with the cleanup request. There is nothing wrong with the tone (underlying emotion of the article). I disagree with the accusation of the use of jargon. The language seems simple as far as is possible, with the unavoidable used of technical vocabulary, which is consistently well defined. As such, the text is understandable to the non-expert and is therefore not jargon. The introduction is excellent for the general reader. As the article progesses, the complexity increases only as is necessary. The authors of this article are to be congratulated. Beland needs to be more specific. --Anthony Duff 21:51, 14 September 2005 (UTC)
- Removed request, please put it on the article page if you want to use it. - FrancisTyers 16:13, 24 December 2005 (UTC)
Is anyone aware of known genetic predispositions specifically to aortic dissection? Are there any foundations pursuing research on this? In my own family, aortic dissection has caused the death of my grandmother (during childbirth with my mother), my aunt, a cousin, and nearly caused the death of my uncle (who survived by a matter of minutes), all people in otherwise excellent health. We have not been able to find anything about this kind of predisposition anywhere. None of my family has any other symptoms of Marfan, but with such a high rate of the exact same condition, it seems like there is likely something congential about it... Does anyone have any information to add to the article, or at least to point me in the right direction? -Porlob 21:07, 6 October 2006 (UTC)
Transthoracic Echo could be listed a valid Diagnostic Modality
Personally, as a sonographer I have diagnosed previously unknown dissections by doing a thorough transthoracic exam. Transthoracic echo may be not be as sensitive as transesophageal echo or CT in diagnosing the full extent of he dissection, especially beyond the aortic arch, but considerably sensitive to the presence of the condition in the proximal aorta up through the arch. —Preceding unsigned comment added by 126.96.36.199 (talk) 20:10, 5 August 2008 (UTC)
>6cm needing emergency surgery
Uploaded a new image
Do you think this would add anything?
- Yes. Shows both dilation and dissection of the ascending aorta. JFW | T@lk 11:24, 12 December 2010 (UTC)
Plans for update
I'm planning an update drive for this article with the eventual aim of producing a Good Article. The 2010 guideline (mentioned above) is very comprehensive and could serve as a scaffold for significant updates. It goes into a fair bit of detail on the management, e.g. malperfusion (a concept not currently mentioned by name in the article), penetrating aortic ulcer as a cause, underlying genetic syndromes and who to screen, etc. Various other recommendations are made, many of which could be included.
- I propose this is moved to a subsection of "diagnosis", because multiple concepts need to be introduced before the classification will make any sense to the reader
- Signs and symptoms
- This should be sourced very tightly, and be separated in sections about predisposition and about provoking events
- We need to talk a bit about aneurysms, but also about the mechanism of the actual dissection. Laplace's law anyone?
- Should we mention the "triple rule out" scan?
- We need more on endovascular management, which has taken off quite impressively
- To be written
- Notable cases
- I propose that this is changed into a "history" section, and that we only preserve the famous people whose illness has made a lasting impact.
- External links
For a good update, I will list some sources here:
- doi:10.1016/S0140-6736(08)60994-0 Lancet 2008 (broad review)
- doi:10.1161/CIR.0b013e3181d4739e Circulation 2010 (American guideline)
- PMID 22199439 Texas Heart Inst J 2011 (historical review, useful)
- doi:10.1016/j.jvs.2011.06.099 J Vasc Surg 2011 (endovascular repair of complicated type B dissections)
- doi:10.1016/j.jacc.2011.06.067 JACC 2011 (provision of surgery for type A dissection)
- doi:10.1016/j.emc.2011.12.001 Emerg Med Clin N Am 2012 (diagnosis and managment)
- doi:10.1136/bmj.d8290 BMJ 2012 (broad review)
- doi:10.1002/bjs.8840 Br J Surg 2012 (type A management)
- doi:10.1016/j.ejvs.2012.07.018 Eur J Vasc Endovasc Surg 2012 (endovascular repair of type A dissections)
- doi:10.1016/j.ahj.2012.10.006 Am Heart J 2013 (biomarkers)
- doi:10.1007/s11547-012-0815-9 Radiol Med 2013 (radiological perspective)
D-dimer has been investigated as a biomarker to exclude aortic dissection in low probability patients: