Chest pain radiating to the back and interscapular region, with shock in presence of risk factors such as hypertension suggest a diagnosis of acute aortic dissection. Loss of pulses occurs when vessel orifices are obstructed by mobile intimal flaps and pulses may well be preserved if such obstruction does not occur. A pleural effusion (left sided) may also be present.
A pleural effusion (usually left sided) may also be present. The effusion is typically serosanguinous and does not indicate rupture unless accompanied by hypotension and falling haematocrit. - Harrison 16 Pain may be localized to the front back of the chest, often in the interscapular region and typically migrates with propagation of lesion.
Severe pain from onset differentiates it from myocardial infarction. Sudden onset pain, severe, tearing associated with diaphoresis. Pulse deficits may be produced obstruction of the branches by compression of the true lumen by distended false lumen or by obstruction of the vessels orfice by mobile intimal flag. Peripheral pulses thus may be normal if the pathologic process does not compromise their orifices.
RISK FACTOR: Risk factor include old age (50-70 yrs), hypertension, females sex, pregnancy bicuspid or unicuspid aortic valve, Noonan or Turner's syndrome, cocaine abuse or connective tissue disorders such as Marfan's Ehler's Danlos syndrome, or arteritis such as Takayasu's or giant cell arteritis.
HOMOEOPATHIC TREATMENT requires a deep constitutional analysis. The history of the disease, the family medical history, physical and mental characteristics of the patient, the likes and dislikes, medication details are all taken into consideration. This approach stands in consonance with the homoeopathic convention: Well selected Homoeopathic remedies are effective for aortic dissection treatment