AORTIC DISSECTION: DIAGNOSTIC APPROACH AND INITIAL MANAGEMENT IN THE EMERGENCY DEPARTMENT

Abstract

Aortic dissection is a serious cardiovascular emergency characterized by the rupture of the aortic intima layer with the formation of a false lumen, which can compromise the perfusion of vital organs and present high mortality when not diagnosed and treated early. Therefore, the objective of this study is to analyze the diagnostic approach and initial management of acute aortic dissection in the emergency department. This is a descriptive literature review, conducted through searches in the PubMed, SciELO, and Lilacs databases, including articles published between 2015 and 2025. The analyzed studies show that computed tomography angiography is the main diagnostic examination in stable patients, while transesophageal echocardiography is relevant in unstable patients. Furthermore, the anatomical classification of the dissection directly guides the initial management, with surgery being the priority in Stanford type A and clinical-hemodynamic management forming the basis of initial treatment in most cases of uncomplicated Stanford type B. It is concluded that early clinical recognition and rapid diagnostic definition are crucial for reducing mortality.