CLINICAL APPROACH TO ACUTE AORTIC DISSECTION IN PATIENTS WITH DECOMPENSATED SYSTEMIC ARTERIAL HYPERTENSION

Abstract

Acute Aortic Dissection (AAD) represents a critical cardiovascular emergency characterized by high morbidity and mortality, with decompensated Systemic Arterial Hypertension (SAH) being its primary risk factor and exacerbating condition. This study aimed to review the clinical approach to AAD in patients with decompensated SAH, given the urgency of effective management to optimize outcomes. The methodology consisted of a systematic literature review, following PRISMA guidelines and the PICO strategy. Five articles were selected from the PubMed, Virtual Health Library (VHL), and SciELO databases, published between 2020 and 2024, in Portuguese and English, specifically addressing the clinical management of AAD in hypertensive patients. The results highlight SAH as a primary etiological factor, the essentiality of early diagnosis through imaging modalities such as contrast-enhanced computed tomography (CTA) and transesophageal echocardiography (TOE), and the necessity of intensive blood pressure and heart rate control as cornerstones of treatment. It is concluded that successful management of AAD in patients with decompensated SAH intrinsically depends on diagnostic speed, aggressive hemodynamic control, and specialized therapeutic intervention, aiming to reduce the high mortality associated with this condition.