Aortic dissection is a severe condition where there is a tear in the wall of the major artery bring blood from the heart (aorta). As the tear extends along the wall of the aorta, blood can flow between the layers of the blood vessel wall (dissection). This can lead to aortic rupture or decreased blood flow (anemia) to organs. This disease also known as Aortic aneurysm – dissecting; Chest discomfort – aortic dissection; Thoracic aortic aneurysm – dissection.
Causes of Aortic Dissection
When it leaves the heart, the aorta initially goes up through the chest towards the head (the rising aorta). It then bends or arches, and lastly moves down through the chest and abdomen (the descending aorta).
Aortic dissection frequently happens because of a tear or harm to the inner wall of the aorta. This extremely typically happens in the chest (thoracic) part of the artery, however it might likewise take place in the stomach aorta.
When a tear occurs, it creates 2 channels:
- One in which blood continues to travel
- Another where blood remains still
If the channel with non-traveling blood grows, it can press on other branches of the aorta. This can narrow the other branches and lower blood flow through them.
An aortic dissection might likewise trigger unusual widening or ballooning of the aorta (aneurysm).
The exact cause is unidentified, however more common threats include:
- Aging
- Atherosclerosis
- Blunt injury to the chest, such as hitting the steering wheel of a vehicle during an accident
- Hypertension
Other risk aspects and conditions connected to aortic dissection include:
- Bicuspid aortic valve
- Coarctation (constricting) of the aorta
- Connective tissue disorders (such as Marfan syndrome and Ehlers-Danlos syndrome) and unusual genetic disorders
- Heart surgery or procedures
- Pregnancy
- Swelling of the blood vessels due to conditions such as arteritis and syphilis
Aortic dissection occurs in about 2 out of every 10,000 people. It can impact anybody, but is most often seen in males ages 40 to 70.
Aortic Aneurysm – Dissecting: Symptoms and Signs
Most of the times, the symptoms start suddenly, and consist of extreme chest discomfort. The pain may seem like a heart attack.
- Discomfort can be referred to as sharp, stabbing, tearing, or ripping.
- It is felt below the chest bone, then moves under the shoulder blades or to the back.
- Discomfort can move to the shoulder, neck, arm, jaw, abdomen, or hips.
- The discomfort changes position, often transferring to the arms and legs as the aortic dissection gets worse.
Signs are caused by a decrease of blood flowing to the rest of the body, and can include:
- Stress and anxiety and a feeling of doom
- Fainting or lightheadedness
- Heavy sweating (clammy skin).
- Nausea and vomiting.
- Pale skin (pallor).
- Fast, weak pulse.
- Shortness of breath and problem breathing when lying flat (orthopnea).
Other symptoms might consist of:
- Discomfort in the abdomen.
- Stroke symptoms.
- Swallowing troubles from pressure on the esophagus.
Diagnosis
The healthcare supplier will take your family history and pay attention to your heart, lungs, and abdomen with a stethoscope. The exam may discover:
- A “blowing” murmur over the aorta, heart whispering, or other irregular noise.
- A distinction in high blood pressure between the right and left arms, or in between the limbs.
- Low blood pressure.
- Indications resembling a cardiovascular disease.
- Indications of shock, however with regular blood pressure.
Aortic dissection or aortic aneurysm may be seen on:
- Aortic angiography.
- Chest x-ray.
- Chest MRI.
- CT scan of chest with dye.
- Doppler ultrasonography (periodically carried out).
- Echocardiogram.
- Transesophageal echocardiogram (TEE).
Blood work to dismiss a cardiovascular disease is required.
Treatment for Aortic Dissection
Aortic dissection is a lethal condition and has to be dealt with immediately.
- Dissections that happen in the part of the aorta that is leaving the heart (ascending) are treated with surgical treatment.
- Dissections that occur in other parts of the aorta (coming down) might be handled with surgery or medications.
Two strategies may be utilized for surgical treatment:
- Requirement, open surgery. This needs a surgical incision that is made in the chest or abdomen.
- Endovascular aortic repair work. This surgical treatment is done without any significant surgical cuts.
Drugs that lower blood pressure might be recommended. These drugs may be provided through a vein (intravenously). Beta-blockers are the first drugs of option. Strong painkiller are really typically required.
If the aortic valve is harmed, valve replacement is required. If the heart arteries are involved, a coronary bypass is likewise carried out.
Outlook (Prognosis)
Aortic dissection is harmful. The condition can be managed with surgical treatment if it is done prior to the aorta ruptures. Less than one half of individuals with a ruptured aorta endure.
Those who survive will need lifelong, aggressive treatment of high blood pressure. They will have to be subsequented with CT scans every couple of months to keep track of the aorta.
Possible Complications
Aortic dissection may reduce or stop the blood flow to various parts of the body. This may result in short-term or long-term problems, or damage to the:
- Brain.
- Heart.
- Intestinal tracts or bowels.
- Kidneys.
- Legs.
When to Contact a Medical Professional
If you have symptoms of an aortic dissection or serious chest discomfort, call 911 or your regional emergency situation number, or go to the emergency clinic as rapidly as possible.
Aortic Dissection Prevention
Numerous cases of aortic dissection can not be prevented.
Things you can do to decrease your risk consist of:.
- Treating and controlling hardening of the arteries (atherosclerosis).
- Keeping hypertension under control, especially if you are at danger for dissection.
- Taking security precautions to avoid injuries that can cause dissections.
- If you have been diagnosed with Marfan or Ehlers-Danlos syndrome, ensuring you frequently follow-up with your provider.
