Decision
Is there evidence for:
- Effusion
- Tamponade
- Dissection flap
Yes
- Administer:
- Fluid/packed red blood cells bolus (Class II)
- Vasopressors to goal systolic blood pressure 100-120 mm Hg (Class III)
- Emergent cardiothoracic surgical consult (Class I)
- Consider controlled pericardial drainage for tamponade (Class III)
- For type A aortic dissection:
- Open repair (Class I)
- endovascular aortic repair if high operative risk (Class II)
- For type B aortic dissection:
- Uncomplicated: endovascular aortic repair vs medical management (Class II)
- Complicated: endovascular aortic repair (Class II)
No
- Consider alternate differentials for shock
