Aortic dissecting aneurysm

Symptoms of aortic dissection may vary. Aortic dissection may occur in patients with arterial hypertension, previous vascular surgery, Marfan syndrome, and other hereditary connective tissue diseases.

A dissecting aortic aneurysm is characterized by sharp pain in the chest or abdomen, symptoms of shock, a pulsating elastic tumor can be detected when palpating the abdomen, the pulse in the arteries of the lower extremities may be absent. Blood pressure in the arms and legs is different.

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Emergency care for dissecting aortic aneurysm

Pain syndrome is relieved by administration of 1-2% trimeperidine solution (0.1 ml per year of life) or 1% morphine solution (0.15 mg/kg) in children over 2 years of age. Ketamine at a dose of 0.5-2 mcg intravenously or 2-6 mg/kg intramuscularly. To relieve psychomotor agitation, it is necessary to administer diazepam at a dose of 0.25-0.5 mg/kg intravenously. Then, infusion therapy of developing hypovolemic shock is carried out |0.9% sodium chloride solution, 5-10% dextrose solution, Ringer's solution is administered at a rate of 10 ml/(kg x h) and under control of arterial pressure, polyglucin]. In recent years, the drug of choice for dissecting aortic aneurysm is considered to be the short-acting ganglion blocker arfonad, which is administered intravenously by drip as a 0.01% solution (50 mg of the drug in 500 ml of 0.9% sodium chloride solution) at an initial rate of 1 mg/min with a gradual increase every 3-5 minutes until the desired effect is achieved (the highest rate is 15 mg/min).

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