Introduction

Acute aortic aneurysm dissection is a life-threatening cardiovascular emergency that requires prompt recognition and management. It occurs when a tear develops in the innermost layer of the aortic wall, allowing blood to enter the middle layer and split the layers apart. This creates a “false lumen” and can impair blood flow. With its increasing prevalence and high mortality if untreated, acute aortic dissection is a critical diagnosis for physicians and pharmacists to rapidly identify and manage collaboratively.

Epidemiology

The incidence of acute aortic dissection ranges from 2 to 3.5 cases per 100,000 person-years. The mean age at presentation is 63 years old, with a male predominance of 3:1. The most common predisposing risk factor is hypertension, present in 60-80% of patients. Other risk factors include connective tissue disorders like Marfan syndrome and Ehlers-Danlos syndrome, bicuspid aortic valve, coarctation of the aorta, family history of aortic disease, atherosclerosis, and prior cardiac surgery. The Stanford classification categorizes dissections involving the ascending aorta as type A, present in 60-70% of cases, while dissections limited to the descending aorta are type B, accounting for 30-40% of cases. Type A dissections have higher in-hospital mortality, reported as high as 1-2% per hour after symptom onset if left untreated. Overall mortality of untreated ascending dissections approaches 50% within the first 48 hours.