Aortic Dissection
Aortic dissection is a serious condition in which there is a tear in the inner layer of the body’s main artery (the aorta). This can cause blood to flow through the tear, splitting the inner and middle layers of the aorta. If blood leaks through the outer aortic wall, it is often life-threatening.
Although relatively rare, aortic dissection usually occurs in men in their 60s and 70s. Symptoms can mimic those of other conditions, often leading to a delay in diagnosis. However, when detected early and treated promptly, the chances of survival are greatly increased.
Symptoms of Aortic Dissection
Symptoms of aortic dissection can be difficult to distinguish from other heart conditions, such as a heart attack. Chest pain and upper back pain are typical symptoms of this condition.
The pain may be severe, and feel like something sharp or tearing in the chest. However, unlike a heart attack, the pain usually starts suddenly and moves around. This is because more parts of the body are affected.
As the condition progresses, you may also experience:
- Jaw pain.
- Neck pain.
- Stomach ache.
- Pain in the shoulder.
- Fainting or dizziness.
- Difficulty breathing.
- Sudden weakness.
- Moist skin.
- Nauseous.
- Vomit.
- Surprised.
Causes of Aortic Dissection
Aortic dissection occurs when the wall of the aorta weakens. Over time, high blood pressure can weaken the aortic tissue. Sometimes, weakness is the result of a condition present at birth that affects the strength or size of the aorta.
One of the triggers is Marfan syndrome. In rare cases, this occurs due to traumatic injury to the chest, such as that caused by a car accident.
Risk Factors for Aortic Dissection
Factors that may increase the risk of developing aortic dissection include:
- High blood pressure (hypertension). This causes direct damage to the aortic tissue layer, eliminating elastic fibers, damaging the wall structure and increasing wall stiffness.
- Atherosclerosis (or plaque buildup in the arteries) or high cholesterol and smoking.
- Aortic aneurysm. This is an abnormal enlargement or bulge in the wall of the aorta.
- Aortic valve disease.
- Congenital heart conditions, such as bicuspid aortic valve or Turner syndrome.
- Connective tissue disorders, such as Marfan syndrome and Ehlers-Danlos syndrome.
- Another hereditary thoracic aortic condition that primarily affects the aorta is also genetically caused.
- Family or genetic history.
- Vasculitis, especially aortitis. This inflammatory disease affects the body’s blood vessels.
- Traumatic injury to the chest.
- Age between 50 and 65 years. The aortic wall loses its elasticity with age.
- Was pregnant and had high blood pressure during delivery.
- Activities that prolong periods of high blood pressure, such as the use of cocaine or amphetamines.
- Heavy powerlifting may increase the rate of aneurysm development or dissection in susceptible individuals.
Diagnosis of Aortic Dissection
To diagnose aortic dissection, there are several examinations that you need to undergo, namely:
- X-ray. This takes pictures of the heart, lungs, and aorta to see if the aorta is widening. This can be a sign of dissection.
- CT Scan. This test shows cross-sections of the chest and abdomen. Doctors use it to check the location and size of the tear.
- Transesophageal Echocardiogram. This test uses sound waves to view the condition of the heart.
- MRI. This gives the doctor a cross-sectional view of the aorta.
- MRA. This will show the doctor how blood flows in the aorta and veins.
- Complete Blood Count Test. This can show if the body is under stress or if the dissection is leaking or rupturing.
Aortic Dissection Treatment
Treatment for aortic dissection may include:
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Endovascular Surgery and Treatment
Surgical options include:
- Graft replacement: Part of the damaged section of the aorta is removed and a synthetic fabric tube (graft) is sewn directly in place.
- Endovascular stent-graft repair: Uses a stent graft to repair the aorta from the inside. Endovascular surgery involves repairs within the aorta.
-
Medicines
Medications, such as beta-blockers, may be prescribed to lower heart rate and blood pressure. In some cases, medication alone may be used to treat the condition initially. Surgery may be delayed for months to years depending on the severity of the tear and the extent of the surgery.
Complications of Aortic Dissection
Possible complications of aortic dissection include:
- Death due to severe internal bleeding.
- Organ damage, such as kidney failure or life-threatening intestinal damage.
- Trauma.
- Damage to the aortic valve (aortic regurgitation) or rupture into the lining around the heart (cardiac tamponade).
Aortic Dissection Prevention
You can reduce your risk of aortic dissection by preventing chest injuries and taking steps to maintain heart health, such as:
- Control blood pressure.
- Do not smoke.
- Maintain ideal body weight.
- Wear a seat belt. This reduces the risk of chest injury during a car accident.
- Regularly check your health condition if you have a high risk.
