What is Aortic Dissection?

An aortic dissection is a severe condition in which the inner layer of the aorta, the large blood vessel offshoot off the heart, tears. Blood urges through the tear, causing the inner and middle layers to separate. If the blood-filled channel bursts through the outside aortic wall, aortic dissection is often fatal.

The aortic direction is relative uncommon accuracy. The condition most frequently happens in men in the 60s and 70s. Signs of aortic dissection may imitate those of other diseases often leading to delays in diagnosis. Nevertheless, when an aortic dissection is identified quickly and treated promptly, the chance of survival significantly improves.

Symptoms of Aortic Dissection

Aortic dissection symptom may close resemble those of other heart problems such as a cardiac arrest or heart attack. Typical signs and symptoms include the following:
Shortness of breath
Weak pulse in on the arm compared to the other.
Loss of vision, Sudden difficulty speaking, weakness or paralysis of one side of your body, similar to those of a stroke.

When should you see a Doctor:
If you have signs or symptoms such as sharp chest pain, sudden onset of shortness of breath, symptoms of a stroke, fainting, call 911 or emergency assistance immediacy. Thes signs and symptoms will not always indicate a serious problem but it is critical to get checked quickly. Early detection and treatment mays help save your life.

Causes
An aortic dissection happens in a weakened area of the aortic wall. Sustained or chronic high blood pressure may stress and wear down the aortic tissue, making it suspectable to tearing. You can also be born with this condition linked with a weakened and enlarged aorta, such as Marfan syndrome, bicuspid aortic valve or other rare conditions linked with a weakening of the walls of the blood vessels. Unusually, aortic dissections are triggered by traumatic injury to the chest area, such as during motor vehicle accidents.
Aortic dissections are segmented into two groups, based on which part of the aorta is affected.
Type A. This more frequent and dangerous type involves a tear in the part of the aorta where it leaves the heart or a tear in the upper or ascending aorta, which can extend to the abdomen.
Type B. This comprises of a tear in the lower aorta only (Design aorta), which may also extend into the abdomen.

Risk Factors
Risk Factors for aortic dissection include:

  • Uncontrolled high blood pressure (hypertension)
  • Weakening and plugin artery (per-exiting aortic aneurysm)
  • An aortic valve defect (bicuspid aortic valve)
  • Uncontrolled high blood pressure (hypertension)
  • A narrowing of the aortic at birth (aortic coarctation)

Certain genetic disease increases the risk of having an aortic dissection, including.

Turner’s syndrome. High blood pressure, heart problems, and some other health conditions may result from this disorder.
Marfan syndrome. This is an ailment in which connective tissue, which holds various structures in the body, is vulnerable. People with this disorder often have a genetic predisposition and family history of aneurysm of the aorta and other blood vessels.
Other connective tissue disorders. This includes Ehlers-Danlos syndrome, a combination of connective tissue disorders designated by skin that blemishes or tears easily, Loose joints and delicate blood vessels and Loeys-Dietz syndrome, with twisted arteries, particularly in the neck.
Inflammatory or infectious conditions. These can cover giant cell arteritis, which is a swelling of the arteries, and syphilis, a sexually transmitted infection.
Other potential risk factors include:

  • Gender- Men have about double the incidence of aortic dissection.
  • Age – Incidences of aortic dissection occur the most in the 60s and 80s.
  • Cocaine use. This drug can be a risk factor for aortic dissection since it briefly raises blood pressure.
  • Pregnancy. Infrequently, aortic dissections happen in otherwise healthy women during pregnancy.
  • High-intensity weightlifting. This and other demanding resistance exercises may increase the risk of aortic dissection by developing blood pressure throughout the activity.

Complications

An aortic dissection can lead to:

  • Death due to severe internal bleeding
  • Organ damage, such as kidney malfunction or life-threatening intestinal injury
  • Aortic valve damage (aortic regurgitation) or rupture into the lining around the heart (cardiac tamponade)
  • Stroke

Test and Diagnosis
Detecting an aortic dissection can be complex because the symptoms are similar to those of a variety of health problems. The doctor often suspect an aortic dissection if the following signs and symptoms are present:

  • Sudden tearing or ripping chest pain.
  • Widening of the aorta on chest X-ray
  • Blood pressure discrepancy between right and left arms

While these signs and symptoms suggest aortic dissection more -sensitive imaging techniques are usually needed.

Frequently used imaging procedures include:

Transesophageal echocardiogram (TEE). This test uses high-pitched sound waves to create an image of the heart. A TEE is a special type of echocardiogram in which an ultrasound probe is injected through the esophagus. The ultrasound probe is situated close to the hat and the aorta, providing a clearer picture of your heart than would a conventional echocardiogram.
Computerized tomography CT scan. Ct scanning generates X-rays to produce cross-sectional photographs of the body, A CT of the chest is applied to diagnose an aortic dissection possibly with an inject contrast liquid. Contrast makes the heart, aorta and other blood vessels more visible on the CT pictures.
Magnetic resonance angiogram (MRA). An MRI utilizes a magnetic field and pulses of radio wave energy to create images of the body. An MRA uses this method to look at blood vessels.

Treatments and Drugs
An aortic dissection is a medical emergency necessitating immediate treatment. Therapy may involve surgery or medications, depending on the area of the aorta involved.
Type An aortic dissection
Treatment for type An aortic dissection may include:

  1. Surgery. Surgeons remove as much of the dissected aorta as possble, block the entry of blood into the aortic wall and replace the aorta with a synthetic tube called a graft. If the aortic valve leaks as a result fo the damaged aorta, it may be replaced at the same stime. The new valve is positioned within the graft used to reconstruct the aorta.
  2. Medications. SOmemedications such as beta blockers and nitroprusside (Nitropress) reduce heart rate and lower blood pressure, which can prevent the aortic dissection from working, They may be given to people with type An aortic dissection to stabilize blood pressure prior to surgery.

Type B aortic dissection

Treatment of Type B aortic section may include:

  1. Surgery. The procedure is comparable to that used to correct a type An aortic dissection. Sometimes stents – small wire mesh tubes that act as a sort of scaffolding – may be placed in the aorta to repair complex type B aortic dissections.
  2. Medications. The same drugs that are used to treat type An aortic dissection may be used without surgery to treat type B aortic dissections.
    After treatment, you might have to take blood pressure lowering medication for life. Also, you may need follow-up CTs or MRIs occasionally to monitor your condition.

Prevention
Here are a few tips to decrease your risk of an aortic dissection:
Control blood pressure. If you have above average blood pressure, get a home blood pressure checking device to help you monitor your blood pressure.
Do not smoke. If you smoke you should stop
Maintain an ideal weight. Follow a low-salt diet with lots of fruits, vegetables, and whole grains and exercise frequently.
Wear a seat belt. This lessens the risk of traumatic injury to your chest area.
Consult with your doctor. If you have a family history of aortic dissection, a connective tissue disorder or a bicuspid aortic valve. Notify your doctor. If you have an aortic aneurysm, fin out how often you need monitoring and if surgery is necessary to repair your aneurysm.
If you have a genetic condition that enhances your risk of aortic dissection, your doctor may prescribe medications even if your blood pressure is normal.

 

 

 

Anatomy of the Heart