CPR and Aortic Dissections

Should you perform CPR on a patient with suspected Aortic Dissection?

While CPR is a life-saving measure, it can, in rare cases, contribute to or worsen an aortic dissection, a tear in the aorta's wall, due to the forceful chest compressions.

Here's a more detailed explanation:

Aortic Dissection:

An aortic dissection occurs when a tear develops in the inner layer (intima) of the aorta, allowing blood to flow between the layers of the arterial wall, potentially leading to a rupture.

CPR and Aortic Dissection:

While CPR is crucial for cardiac arrest, the forceful chest compressions can put significant pressure on the aorta, potentially causing a tear or rupture, especially in individuals with pre-existing aortic conditions.

Rare but Serious:

Aortic dissection as a complication of CPR is rare, but it's important to recognize it as a potential risk, especially when performed with mechanical chest compression devices.

Importance of Early Detection:

If aortic dissection is suspected after CPR, prompt diagnosis and treatment are crucial, potentially involving surgery to repair the aorta.

Considerations for CPR:

When performing CPR, it's important to be aware of the potential risks to the aorta and to ensure that compressions are performed correctly and with appropriate force and depth.

Extracorporeal CPR:

Extracorporeal CPR (ECPR), which involves using a heart-lung machine to support circulation, is sometimes used in cases of acute aortic dissection during cardiac arrest, but its effectiveness and risks are still being studied.

High Mortality:

Aortic dissection in conjunction with cardiopulmonary arrest is associated with high mortality rates, especially if the dissection is not recognized and treated promptly.

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