Primary prevention

Hypertension should be assessed for and treated appropriately in all patients.[5]​ Other cardiovascular risk factors (e.g., dyslipidaemia and diabetes mellitus) should be intensively managed. Smokers should be encouraged to cease smoking, and offered counselling and/or smoking cessation therapy if they are willing. Drug use (specifically cocaine) is associated with aortic dissection, and should be strongly discouraged in patients with concomitant risk factors.​[15][19][27]​[28]​​​​​​

Secondary prevention

Patients with known Marfan or Ehlers-Danlos syndrome should be regularly monitored with echocardiography for aortic root aneurysm (predisposing to dissection).[6][31]​

Manage the patient’s blood pressure and heart rate very carefully. Aim for a target blood pressure of <120/80 mmHg, and a heart rate ≤60 beats per minute.[17]

Beta blockade is first-line treatment.

Use of this content is subject to our disclaimer