https://academic.oup.com/eurheartj/article/35/41/2873/407693
Pain between the scapulae
Difference in BP between the arms
Two most common causes:
An important distinction between the two is that hypertensive dissections generally originate in the ascending aorta, at an intimal surface free of atherosclerosis.
Dissection secondary to atherosclerosis is typically the consequence of a ruptured aortic aneurysm, which originates in the abdominal aorta at the iliac bifurcation.
Dissections due to both hypertension and atherosclerosis generally course through the wall within the media
Dissection of the descending aorta tends to propagate proximally and distally along the left lateral side of aorta. The renal arteries are lateral branches of the abdominal aorta. Therefore, the ostium of the left renal artery may be involved in aortic dissection.
Because of the proximity of the descending aorta and left mediastinal pleura, rupture into left pleural cavity and left hemithorax may also occur.
Acute type A (i.e. DeBakey type I & II - ascending aorta +/- root) aortic disseciton can extend into the pericardial space, causing hemopericardium and rapidly progressing to cardiac tamponade and cardiogenic shock.
Standford type A (proximal) - Ascending aorta
Standford type B (distal) - Beyond the arch
Complications of backward tear
Complications of forward tear