Ascending aortic arch aneurysms and dissections: discussion and nursing management

Ascending aortic arch aneurysms and aortic dissections are serious conditions with high mortality and morbidity. Aneurysms can be defined according to morphology or location and are usually precipitated by atherosclerosis or cystic medial necrosis. Intact aortic aneurysms are often asymptomatic, while chest pain is frequently the predominant symptom associated with aortic dissections. The diverse clinical presentation of aneurysms and dissections makes diagnosis difficult. When the aneurysm is large or the patient is symptomatic, surgical intervention is the preferred treatment and consists of replacing a segment of the aorta with a synthetic graft. Postoperative nursing care focuses on altered tissue perfusion, fluid volume deficit, potential respiratory insufficiency and patient teaching.