Acute aortic syndrome
) describes a range of severe, painful
, potentially life-threatening abnormalities of the aorta
. These include aortic dissection
, intramural thrombus
, and penetrating atherosclerotic aortic ulcer
. AAS can be caused by a lesion
on the wall of the aorta
that involves the tunica media
, often in the descending aorta
. It is possible for AAS to lead to acute coronary syndrome
. The term was introduced in 2001.
Causes can include aortic dissection
, intramural hematoma
, penetrating atherosclerotic ulcer
or a thoracic aneurysm
that has become unstable. The potential causes of AAS are life-threatening and present with similar symptoms, making it difficult to distinguish the ultimate cause, though high resolution, high contrast computerised tomography
can be used.
The condition can be mimicked by a ruptured cyst
of the pericardium
, ruptured aortic aneurysm
and acute coronary syndrome
Misdiagnosis is estimated at 39% and is associated with delays correct diagnosis and improper treatment with anticoagulants producing excessive bleeding and extended hospital stays.
AAS is life-threatening, with a high mortality rate if appearing acutely, reduced only when diagnosed early and treated by a surgeon with considerable expertise. If patients survive acute presentation, within three to five years 30% will develop complications and require close follow-up. Early diagnosis is essential for survival and management is challenging though greater awareness of the syndrome and improving management strategies are improving patient outcomes.