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| <div style="-webkit-user-select: none;">
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| ==New==
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| {| style="width: 100%; font-size: 90%;"
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| | style="width: 10%;" valign=top |
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| <font color="#FF0000">'''''Click on boxes to expand/collapse detailed information.'''''</font>
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| {{Family tree/start}}
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| {{Family tree|border=0| | | | | | | | A01 | | | | | | | | | | |A01=
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| <div class="mw-customtoggle-box1" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|xxxxxx}}
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| </div>}}
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| {{Family tree|border=0| | | | | | | | |!| | | | | | |}}
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| {{Family tree|border=0| | | | | | | | A02 | | | | | |A02=
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| <div class="mw-customtoggle-box2" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|xxxxxx}}
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| </div>}}
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| {{Family tree|border=0| | | | | | | | |!| | | | | | |}}
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| {{Family tree|border=0| | | | | | | | A03 | | | | | |A03=
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| <div class="mw-customtoggle-box3" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|xxxxxx}}
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| </div>}}
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| {{Family tree|border=0| | | | | | | | |!| | | | | | |}}
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| {{Family tree|border=0| | | | | | | | A04 | | | | | |A04=
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| <div class="mw-customtoggle-box4" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|xxxxxx}}
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| </div>}}
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| {{Family tree|border=0| | | | | | | | |!| | | | | | |}}
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| {{Family tree|border=0| | | | | | | | A05 | | | | | |A05=
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| <div class="mw-customtoggle-box5" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|xxxxxx}}
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| </div>}}
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| {{Family tree|border=0| | | | | | | | |!| | | | | | |}}
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| {{Family tree|border=0| | | | | | | | A06 | | | | | |A06=
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| <div class="mw-customtoggle-box6" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|xxxxxx}}
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| </div>}}
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| {{Family tree|border=0| | | | | | | | |!| | | | | | |}}
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| {{Family tree|border=0| | | | | | | | A07 | | | | | |A07=
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| <div class="mw-customtoggle-box7" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|xxxxxx}}
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| </div>}}
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| {{Family tree|border=0| | | | | | | | |!| | | | | | |}}
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| {{Family tree|border=0| | | | | | | | A08 | | | | |A08=
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| <div class="mw-customtoggle-box8" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|xxxxxx}}
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| </div>}}
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| {{Family tree|border=0| | | | |,|-|-|-|^|-|-|-|.| |}}
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| {{Family tree|border=0| | | | A09 | | | | | | A10 |A09=
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| <div class="mw-customtoggle-box9" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|Syncope}}
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| </div>
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| |A10=
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| <div class="mw-customtoggle-box10" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|Non syncope loss of consciousness}}
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| </div>}}
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| {{Family tree|border=0| | |,|-|^|-|.| | | | | |!| | }}
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| {{Family tree|border=0| | A11 | | A12 | | | | A13 | A11=
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| <div class="mw-customtoggle-box11" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|'''Known etiology''' <br> Cardiovascular <br> Orthostatic hypotension <br> Reflex}}
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| </div>
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| |A12=
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| <div class="mw-customtoggle-box12" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|'''Unknown etiology'''<br> Determine if there are any high risk criteria: }}
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| </div>
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| |A13=
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| <div class="mw-customtoggle-box13" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|Consider additional tests}}
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| </div>}}
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| {{Family tree|border=0| | | | |,|-|^|-|.| | | |!| | |}}
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| {{Family tree|border=0| | | | A14 | | A15 | | A16 | |A14=
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| <div class="mw-customtoggle-box14" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|High risk}}
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| </div>
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| |A15=
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| <div class="mw-customtoggle-box15" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|low risk}}
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| </div>
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| |A16=
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| <div class="mw-customtoggle-box16" style="cursor: pointer; border-radius: 5px 5px 5px 5px; text-align: center; border: solid 1px #696969; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: inset 0 1px 1px rgba(255, 255, 255, 0.5), 0 1px 1px rgba(0, 0, 0, 0.5); background: #4682B4; width: 200%;">
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| {{fontcolor|#F8F8FF|Consider alternative diagnoses}}
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| </div>}}
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| {{Family tree/end}}
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|
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| </div>
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|
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| | style="width: 100%; font-size: 100%;" valign=top |
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| <div class="mw-collapsible mw-collapsed" id="mw-customcollapsible-box1" style="background: #B8B8B8; padding: 5px 10px;">
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|
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| ==Characterize the symptoms==
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| </div>
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| |}
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|
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| ==Old==
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|
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| {{familytree/start}}
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| {{familytree | | | | | | | | | | A01 |-| A02 |-|-|.| | | | |A01=<div style="float: left; text-align: left; width:20em; padding:1em">❑ Imaging study confirms aortic dissection <br> ❑ Check whether dissection occurred in ascending aorta </div>|A02=No }}
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| {{familytree | | | | | | | | | | |!| | | | | | | |!| | | | }}
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| {{familytree | | | | | | | | | | A03 | | | | | | |!| | | | |A03=Yes}}
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| {{familytree | | | | | | | | | | |!| | | | | | | |!| | | | }}
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| {{familytree | | | | | | | | | | B01 |-| B02 |-| B03 | | |B01=<div style="float: left; text-align: left; width:20em; padding:1em">❑ Assess suitability for surgery <br>❑ Patient stable for pre-op testing?</div> |B02=No |B03=Medical management }}
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| {{familytree | | | | | | | | | | |!| | | | | | | | | | | | }}
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| {{familytree | | | | | | | | | | C01 | | | | | | | | | | |C01=Yes }}
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| {{familytree | | | | | | | | | | |!| | | | | | | | | | | | }}
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| {{familytree | | | | | | | | | | D01 |-| D02 |-|.| | | |D01=<div style="float: left; text-align: left; width:20em; padding:1em">❑ Age>40? </div>|D02=No }}
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| {{familytree | | | | | | | | | | |!| | | | | | |!| | | | }}
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| {{familytree | | | | | | | | | | E01 | | | | | |!| | | |E01=Yes }}
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| {{familytree | | | | | | | | | | |!| | | | | | |!| | | | }}
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| {{familytree | | | | | | | | | | F01 |-| F02 |-|(| | | |F01=<div style="float: left; text-align: left; width:20em; padding:1em">❑ Assess need for pre-operative coronary angiography <br>
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| :❑ Known CAD?
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| :❑ Significant risk factors for CAD? </div>|F02=No}}
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| {{familytree | | | | | | | | | | |!| | | | | | |!| | | | }}
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| {{familytree | | | | | | | | | | G01 | | | | | |!| | | |G01=Yes }}
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| {{familytree | | | | | | | | | | |!| | | | | | |!| | | | }}
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| {{familytree | | | | | | | | | | H01 |-| H02 |-|(| | | |H01=<div style="float: left; text-align: left; width:20em; padding:1em">❑ Perform angiography <br> Is significant CAD detected on angiography?</div> |H02=No }}
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| {{familytree | | | | | | | | | | |!| | | | | | |!| | | | }}
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| {{familytree | | | | | | | | | | I01 | | | | | |!| | | |I01=Yes }}
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| {{familytree | | | | | | | | | | |!| | | | | | |!| | | | }}
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| {{familytree | | | | | | | | | | J01 | | | | | |!| | | |J01=<div style="float: left; text-align: left; width:20em; padding:1em">❑ Plan for CABG at the time of aortic dissection repair </div> }}
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| {{familytree | | | | | | | | | | |!| | | | | | |!| | | | }}
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| {{familytree | | | | | | | | | | K01 |-|-|-|-|-|'| | | |K01=<div style="float: left; text-align: left; width:20em; padding:1em">❑ Perform urgent operative management </div>}}
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| {{familytree | | | | | | | | | | |!| | | | | | | | | | | | }}
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| {{familytree | | | | | | |,|-|-| L01 | | | | | | | | | | |L01=<div style="float: left; text-align: left; width:20em; padding:1em">❑ Perform intra-operative assessment of aortic valve by TEE for presence of one of the following: <br>
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| :❑ Aortic regurgitation <br>
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| :❑ Dissection of aortic sinuses </div>}}
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| {{familytree | | | | | | |!| | | |!| | | | | | | | | | | | }}
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| {{familytree | | | | | | M01 | | M02 | | | | | | |M01=No |M02=Yes }}
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| {{familytree | | | | | | |!| | | |!| | | | | | | | }}
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| {{familytree | | | | | | N01 | | N02 | | | | | | |N01=<div style="float: left; text-align: left; width:20em; padding:1em">❑ Perform graft replacement of ascending aorta ± aortic arch </div> |N02=<div style="float: left; text-align: left; width:15em; padding:1em">❑ Perform graft replacement of ascending aorta ± aortic arch <br>❑ Consider repair/replacement of aortic valve </div>}}
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