A 45 you female presents complaining of abdominal pain and back pain.  She apears uncomfortable and she has hypertension on exam, otherwise vital signs are normal and exam is unremarkable.  A CT is completed.  What's the diagnosis?  Scroll down for answer.

Answer:  Aortic Dissection

• A flap is clearly seen in the descending aorta
• Occurs when the blood enters the medial layer of the aortic wall through a defect in the intima layer, blood will fill into this new lumen
• Most aortic dissectins occur in elderly hypertensive patients
• Treatment involves aggressive heart rate and blood pressure management (beta blockade and peripheral arterial relaxation)
• Type A dissections (involving the ascending aorta) require surgical management, Type B dissections (involving the descending aorta only) are often managed medically