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Aortic dissection is a dangerous disorder in which the inner layer of the body's major artery (aorta) tears. Blood rushes through the tear, causing the aorta's inner and middle layers to split (dissect). Aortic dissection is generally fatal if the blood passes through the outside aortic wall.
Aortic dissection is a rather uncommon condition. It typically affects men in their 60s and 70s. Aortic dissection symptoms can mirror those of other disorders, causing diagnostic delays. When an aortic dissection is diagnosed early and treated swiftly, the chances of survival rise dramatically.
WHAT ARE THE SYMPTOMS OF AORTIC DISSECTION?
Symptoms of aortic dissection may be similar to those of other heart issues, such as a heart attack. The following are typical signs and symptoms:
- Sudden acute chest or upper back pain that travels to the neck or down the back, commonly described as tearing or ripping
- Severe abdominal ache that occurs suddenly
- Consciousness loss
- Breathing difficulty
- Symptoms comparable to a stroke, such as sudden vision issues, trouble speaking, and weakness or lack of movement on one side of your body (paralysis).
- One arm or thigh has a weaker pulse than the other.
- Leg ache
- Walking difficulty
WHAT ARE THE CAUSES OF AORTIC DISSECTION?
Aortic dissection is caused by a weakening segment of the aortic wall.
Aortic dissections are classified into two types based on whether part of the aorta is affected:
- Type A: This is the more common and dangerous kind, which involves a tear in the aorta as it exits the heart. The upper aorta (ascending aorta) can potentially rip and extend into the abdomen.
- Type B: This type is characterized by a rip in the lower aorta (descending aorta), which may extend into the belly.
WHAT ARE THE RISK FACTORS FOR AORTIC DISSECTION?
Some factors that may increase your risk of aortic dissection include:
- High blood pressure that is uncontrolled (hypertension)
- Hardening of the arteries (atherosclerosis)
- A weak and bulging artery (aortic aneurysm)
- An aortic valve defect (bicuspid aortic valve)
- A narrowing of the aorta at birth (aortic coarctation)
Aortic dissection is more likely in those who have certain hereditary illnesses, such as:
- Turner syndrome: This illness can cause high blood pressure, heart issues, and other health problems.
- Marfan syndromess: This is a condition in which the connective tissue that supports the body's numerous tissues is weak. People with this illness frequently have a family history of aortic and other blood vessel aneurysms or aortic dissections.
- Other connective tissue problems: Ehlers-Danlos syndrome is a series of connective tissue illnesses characterized by loose joints and weak blood vessels, and Loeys-Dietz syndrome is characterized by twisted arteries, particularly in the neck.
Aortic dissection is also increased by artery inflammation (giant cell arteritis).
Other potential aortic dissection risk factors include:
- Sex: Aortic dissection is more common in men than in women.
- Age: Aortic dissection is more common in adults above the age of 60.
- Use of cocaine: This medication briefly elevates blood pressure.
- Pregnancy: Aortic dissections are uncommon in normally healthy pregnant women.
- Weightlifting at high intensity: By boosting blood pressure during the activity, this and other rigorous resistance training may increase your risk of aortic dissection.
WHAT ARE THE COMPLICATIONS OF AORTIC DISSECTION?
Aortic dissection can lead to the following complications:
- Death as a result of significant internal bleeding
- Damage to organs, such as kidney failure or potentially fatal intestinal damage
- Stroke
- Aortic valve injury (aortic regurgitation) or rupture into the heart lining (cardiac tamponade)
HOW IS AORTIC DISSECTION DIAGNOSED?
The symptoms of an aortic dissection are similar to those of many other health issues, making detection difficult. If you have any of the following symptoms, your doctor may suspect you have an aortic dissection:
- Chest pain that tears or rips suddenly
- Difference in blood pressure between the right and left arms
- Widening of the aorta on chest X-ray
Aortic dissection is diagnosed using the following tests:
- Transesophageal echocardiogram (TEE): This test use sound waves to generate images of the heart in motion. A transesophageal echocardiography (TEE) is a form of echocardiogram in which an ultrasound probe (transducer) is passed into your esophagus and placed near your heart. This test provides your doctor with a more detailed picture of your heart and aorta than a standard echocardiogram.
- Computerized tomography (CT) scan of the chest: Cross-sectional images of the body are created using X-rays. A CT scan of the chest can confirm an aortic dissection diagnosis.
- Magnetic resonance angiogram (MRA): An MRA creates images of your blood arteries using a magnetic field and radio wave energy.
WHAT ARE THE TREATMENTS FOR AORTIC DISSECTION?
Aortic dissection is a medical emergency that requires quick attention. Depending on the section of the aorta implicated, treatment may include surgery or medicines.
Type A aortic dissection
Treatment options for type A aortic dissection include:
- Surgery: Surgeons remove as much as possible of the dissected aorta to prevent blood from leaking into the aortic wall. The aorta is rebuilt using a synthetic tube (transplant). If the aortic valve leaks as a result of the damaged aorta, it may be replaced together with the aorta. The new valve is inserted into the graft.
- Medications: Medications are administered to control heart rate and blood pressure, so preventing the aortic dissection from deteriorating. People with type A aortic dissection may be given them to manage their blood pressure before surgery.
Type B aortic dissection
The following procedures may be used to treat type B aortic dissection:
- Medications: The same drugs that are used to treat type A aortic dissections can be used to treat type B aortic dissections without surgery.
- Surgery: The operation is identical to that done to repair a type A aortic dissection. Stents, which are small wire mesh tubes that act as scaffolding, are sometimes used to heal difficult type B aortic dissections.
Following treatment, you may need to take blood pressure medicine for the rest of your life. Regular CT or MRI scans may be required to monitor your condition.
HOW CAN AORTIC DISSECTION BE PREVENTED?
You can lower your chances of having an aortic dissection by avoiding chest injuries and taking actions to keep your heart healthy.
- Maintain blood pressure control: If you have high blood pressure, invest in a home blood pressure measuring gadget to help you keep track of it.
- Don't smoke: If you smoke, make an effort to quit.
- Maintain a healthy weight: Maintain a low-salt diet rich in fruits, vegetables, and whole grains, and engage in frequent physical activity.
- Use a seat belt: This decreases the danger of chest injuries in the event of an automobile collision.
- Consult your doctor: Inform your doctor if you have a family history of aortic dissection, a connective tissue condition, or a bicuspid aortic valve. If you have an aortic aneurysm, find out how frequently you need to be monitored and whether surgery is required to repair your aneurysm.
Even if your blood pressure is normal, your doctor may recommend drugs if you have a genetic disease that raises your chance of aortic dissection.