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Stanford Type A aortic dissection — MCCQE Part 1 MCQ

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HardChest PainStanford Type A aortic dissectionMCCQE Part 1

A 50-year-old man has sudden tearing chest pain radiating to back. BP 210/120 right arm, 170/90 left arm. New AR murmur. CT angiography: Stanford type A dissection. Most appropriate management?

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Correct answer: C — Emergent cardiothoracic surgical repair

Type A (ascending aorta): surgical emergency. Mortality ~1-2% per hour untreated. Type B (descending only): medical management unless complicated. BP control with IV beta-blocker targeting HR <60 while arranging surgery.

Reference: CCS / Canadian CVT Surgery