What is Aortic Dissection?

Aortic dissection is a life-threatening condition in which the inner layer of the body's main artery tears (aorta). The inner and middle layers of the aorta split as blood rushes through the tear (dissect). Aortic dissection is often fatal if blood passes through the outside aortic wall. Aortic dissection is a rare occurrence. It mostly affects men in their 60s and 70s. Aortic dissection symptoms can be mistaken for those of other diseases, causing diagnostic delays. When an aortic dissection is detected early and treated early, the chances of survival improve.


Symptoms

The symptoms of an aortic dissection may resemble those of other heart conditions, such as a heart attack. The following are some signs and symptoms:

  • Sudden severe chest or upper back pain that spreads to the neck or down the back and is often described as tearing or ripping.
  • Severe stomach pain that appears suddenly
  • Poor Concentration
  • Breathlessness

Symptoms that are similar to those of a stroke, such as sudden vision problems, difficulty speaking, and weakness or paralysis on one side of the body

  • In comparison to the other, one arm or thigh has a weak pulse.
  • Pain in the legs
  • Walking problems

Causes

  • A weakened area of the aorta's wall causes an aortic dissection.
  • Depending on which part of the aorta is affected, aortic dissections are divided into two groups:
  • Type A - A tear in the part of the aorta where it exits the heart is the more common and dangerous type. A tear in the ascending aorta (upper aorta) that extends into the abdomen is also possible.
  • Type B - It is the most common. This type is characterized by a tear in the lower aorta (descending aorta), which may extend into the abdomen.

Diagnosis

The symptoms of aortic dissection are similar to those of many other health issues, making detection difficult. If you experience any of the following symptoms, your doctor may suspect you have an aortic dissection:

  • Chest Pain
  • The difference in blood pressure between the right and left arms
  • Aortic widening can be seen on a chest X-ray.

Aortic dissection can be detected using the following tests:

  • Transesophageal echocardiography (TEE) (TEE). This test employs sound waves to generate images of the heart in action. Transesophageal echocardiography (TEE) is a form of echocardiogram in which an ultrasound probe (transducer) is passed into your esophagus and positioned near your heart. This test provides your doctor with a more detailed view of your heart and aorta than a standard echocardiogram.
  • A chest CT scan is a type of computerized tomography (CT) scan. Cross-sectional pictures of the body are created using X-rays. A CT scan of the chest can confirm an aortic dissection diagnosis.
  • Angiogram using magnetic resonance imaging (MRA). An MRA creates pictures of your blood arteries using a magnetic field and radio wave radiation.

Treatment

Aortic dissection is a medical emergency that requires quick attention. Depending on the section of the aorta implicated, treatment may include surgery or medicines.

Aortic Dissection of Type A

The following procedures may be used to treat type A Aortic Dissection:

Surgeons remove as much of the dissected aorta as possible to prevent blood from entering 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 replacement valve is inserted into the graft.

Medications are used for controlling your heart rate and blood pressure, so it helps in preventing the aortic dissection from deteriorating. People with type A aortic dissection may be given to manage their blood pressure before surgery.

Aortic Dissection of Type B

The following procedures may be used to treat type B aortic dissection:

The same medications used to treat type A aortic dissections can also be used to treat type B aortic dissections without surgery.

The operation is identical to that done to repair a type A aortic dissection. Stents, which are tiny wire mesh tubes that function as scaffolding in the aorta, are sometimes used to treat difficult type B aortic dissections.

Risk Factors

Aortic dissection can be caused by a variety of factors, including:

  • High blood pressure that is uncontrolled (hypertension)
  • Atherosclerosis (hardening of the arteries) (atherosclerosis)
  • The artery that is weakened and bulging (aortic aneurysm)
  • Aortic valve stenosis is a condition in which the aortic valve (bicuspid aortic valve)
  • Aortic stenosis (narrowing of the aorta) at birth (aortic coarctation)

Aortic dissection is more likely in people who have certain genetic diseases, such as:

  • Turner's syndrome is a condition that can cause high blood pressure, heart problems, and other health problems.
  • Marfan syndrome is a condition that affects people of all ages. This is a condition in which the connective tissue that supports the body's various structures is weak. A family history of aortic aneurysms and other blood vessel aneurysms, as well as aortic dissections, is common in people with this disorder.
  • Other conditions affect the connective tissue. Ehlers-Danlos syndrome is a group of connective tissue disorders characterized by loose joints and fragile blood vessels, and Loeys-Dietz syndrome is characterized by twisted arteries, particularly in the neck.
  • Inflammation of the arteries (giant cell arteritis) may also increase your chances of having an aortic dissection.

Complications

  • Death as a result of significant internal bleeding
  • Organ damage, such as renal failure or life-threatening intestine injury
  • Stroke
  • Aortic valve injury (aortic regurgitation) or rupture into the heart's lining (cardiac tamponade)

When Should You See A Doctor?

Immediately contact your healthcare professional if you have severe chest pain, fainting, sudden shortness of breath, or stroke symptoms. Although these signs and symptoms aren't always indicative of a serious problem, it's best to see a doctor as soon as possible. It's possible that early detection and treatment will save your life.

Prevention

  • By avoiding chest traumas and taking steps to maintain your heart healthy, you can reduce your chances of having an aortic dissection.
  • Maintain healthy blood pressure- If you have high blood pressure, invest in a home blood pressure measuring machine to help you keep track of it.
  • Quit Smoking - Smoking will risk your life. Do not smoke.
  • 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 while driving - This decreases the possibility of sustaining a chest injury in the event of an automobile collision.

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Frequently Asked Questions

1. How long can a person live with an aortic dissection?

Although specific data on overall life expectancy following aortic dissection repair is not available, a recent study from the International Registry of Acute Aortic Dissection found that approximately 85 percent of patients who underwent successful repair of an acute dissection involving the ascending aorta remain alive.

2. What happens during an aortic dissection?

During an aortic dissection, the inner layer of the aorta breaks, allowing blood to enter places it should not. As a result, the inner and middle layers separate, or dissect. If blood breaks through the outer wall of your aorta, it is life-threatening and must be repaired immediately.

3. Can an aortic dissection heal itself?

The dissection may heal slowly on its own or trigger an aortic wall rupture. Depending on the magnitude, a rupture like this can kill someone instantaneously or within a few days.