The patient was placed on intravenous nitrate therapy and given aspirin. He was emergently taken for cardiac catheterization to rule out the possibility of aortic dissection, as well as address the ongoing infarction. The catheterization revealed a Type A, or Type I aortic dissection and the patient was redirected to the operating room where he underwent successful repair. The aortic wall consists of the intima, media, and adventitia. Dissection occurs by longitudinal cleavage of the media by a column of blood.
Aortic dissection has a predilection for the thoracic aorta.
Isolated abdominal dissections are rare. Dissecting aneurysm is a misnomer and should not be used. While chronic dissections of the aorta may result in aneurysmal dilation, this is uncommon and generally does not occur. Acute dissections of the aorta do not cause aneurysmal dilation. The dissecting column of blood will propagate either anterograde, retrograde or both.