Acute aortic syndromes: An internist's guide to the galaxy

Acute aortic syndromes (AASs) are severe conditions defined by dissection, hemorrhage, ulceration or rupture of the thoracic aorta. AASs share etiological and pathophysiological features, including long-term aortic tissue degeneration and mechanisms of acute aortic damage. The clinical signs and symptoms of AASs are unspecific and heterogeneous, requiring large differential diagnosis. When evaluating a patient with AAS-compatible symptoms, physicians need to integrate clinical probability assessment, bedside imaging techniques such as point-of-care ultrasound, and blood test results such as D-dimer. The natural history of AASs is dominated by engagement of ischemic, coagulative and inflammatory pathways at large, causing multiorgan damage. Medical treatment, multiorgan monitoring and outcome prognostication are therefore paramount, with internal medicine playing a key role in non-surgical management of AASs.

Automated summary

Acute aortic syndromes (AASs) are severe conditions characterized by dissection, hemorrhage, ulceration or rupture of the thoracic aorta. The clinical signs and symptoms are nonspecific and require comprehensive differential diagnosis. Physicians need to integrate clinical probability assessment, bedside imaging techniques, and blood test results to evaluate patients with AAS-compatible symptoms. The natural history of AASs is dominated by engagement of ischemic, coagulative and inflammatory pathways, causing multiorgan damage. Internal medicine plays a key role in non-surgical management of AASs.