This case illustrates a Stanford Class A and De Bakey type 1 acute aortic dissection.

An aortic dissection refers to the tear of the tunica intima and media in the wall of the aorta with resulting ingress of blood, forming a false lumen, with variable proximal and/or distal extension^1,2.  The dissection is termed^2,3:

• Acute if the diagnosis is made within 14 days following the initial onset of symptoms
• Chronic if present for more that two weeks

There are two classification systems used for the staging of an aortic dissection^2,4:

1. Stanford Classification

• The Stanford classification of aortic dissection distinguishes between type A and type B, depending on whether the ascending aorta is involved
  • Type A: The dissection involves the ascending aorta
  • Type B: The dissection involves the descending aorta only

2. De Bakey Classification

• The De Bakey classification categorizes the dissection based on where the original intimal tear is located and the extent of the dissection
  • Type I: The dissection involves ascending aorta, aortic arch, and descending aorta.
  • Type II: The dissection is confined to ascending aorta only
  • Type III: The dissection is confined to descending aorta distal to the left subclavian artery only.