Aortic Dissection

Aortic dissection is a life-threatening condition in which there is a tear in the inner layer of the body's major artery (aorta) carrying blood out of the heart . The aorta carries oxygen-rich blood from the heart to the rest of the body. It has three tissue layers: an inner layer, a middle layer, and an exterior layer. Aortic dissection happens when a tear develops in the inner layer of a weaker part of the aorta. Normal blood flow to different parts of the body may be reduced or interrupted when diverted blood travels between tissue layers, or the aorta may rupture altogether.

Aortic dissections are separated into two groups, depending on which part of the aorta is affected:

Type A : A typical and dangerous type involving a tear in the aorta section where it exits the heart. There can also be a tear in the upper aorta (ascending aorta), which may advance into the abdomen.
Type B : It involves a tear in the lower aorta (descending aorta), which may advance into the abdomen.

Symptoms

Aortic dissection symptoms might be similar to those of other disorders. One might also have symptoms of a heart attack. Few people are not in pain. The most common symptoms are as follows:

Loss of vision
Loss of consciousness
Shortness of breath
Fever
A weaker pulse in one arm than the other
Pale skin
Fainting or dizziness
Nausea
Profuse sweating
Sudden, severe upper back or chest pain
Leg pain
Mild neck, jaw, or chest pain
Sudden trouble speaking
Paralysis or weakness on one side of the body,
Tingling, numbness, or pain in the toes or fingers
Trouble walking

When to see a doctor?

If you have severe chest discomfort, fainting, abrupt shortness of breath, or stroke symptoms, call the doctor right away. These signs and symptoms aren't necessarily indicative of a major condition, but it's essential to consult a doctor as soon as possible. Aortic dissection can have serious effects, including organ failure or serious health problems if it is not treated immediately. Early detection and treatment may help you live longer.

Causes

Aortic dissection is a tear or damage in the inner aortic wall.
Aortic dissection often develops when the blood pressure is high, the aortic tissue weakens allowing the aorta layers to break easily.
Aortic dissection might be caused by a condition that a person has had since birth.
Rarely, aortic dissection can happen as a result of a vehicle accident. This occurs when the chest, or any region of the chest, is severely harmed in an accident.

Risk factors

Aortic dissection is rare. The following are risk factors for the condition:

Age : The majority of abdominal aortic aneurysms occur in adults over the age of 65.
Aortic valve issues : People who are born with a bicuspid aortic valve are more likely to develop aortic aneurysms. Gender: Men are more likely than women to have abdominal aortic aneurysms
Connective tissue disease : Aortic aneurysms can be caused by connective tissue disorders, such as Marfan syndrome.
High blood pressure : High blood pressure : Long-term hypertension puts extra strain on the arterial walls, increasing their susceptibility to rupture.
An infectious or inflammatory condition : Syphilis or artery inflammation caused by giant cell arteritis or Takayasu's arteritis can raise the risk of aortic dissection.
Trauma to the chest : A severe chest injury may, in rare cases, lead to an aortic tear.
Pregnancy : Aortic dissections can occur in rare circumstances during pregnancy.
High-intensity weightlifting : This type of resistance training increases blood pressure which might cause an aortic tear.

Complications

Diagnosis of aortic dissection can be challenging. The condition and symptoms might be confused with those of different conditions. Because an aortic dissection can cause serious damage in a short period of time, it must be diagnosed and treated as soon as possible. Without proper medical care, this condition can lead to catastrophic consequences, such as

Aortic regurgitation
Heart attack
Cardiac tamponade
Organ failure
Aortic rupture
Heart failure

Prevention

People at risk of aortic dissection, especially those with a family history, can minimise their risk by adopting healthy lifestyle changes. The following are some methods for preventing Aortic Dissection.

Getting regular heart examinations.
Monitoring blood pressure regularly and receiving treatment for hypertension.
Consuming a balanced diet rich in whole grains, fruits, and vegetables while limiting salt intake.
Exercising regularly
Maintaining a healthy body weight
Avoiding smoking
Following a treatment plan for any existing medical conditions that increase the risk of aortic dissection.
Wearing a seat belt when driving to reduce the likelihood of chest injuries.

Diagnosis

A doctor will inquire about the medical history and do a physical examination to identify aortic dissection. The following signs and symptoms can help in diagnosing the condition:

An abnormal heartbeat
Blood pressure differences between the left and right arms.
Sudden and acute pain in the chest, back, or abdomen.

Chest X-ray : Chest X-ray: A widening of the aorta can be seen on a chest X-ray. However, because the pictures may seem normal in 10 to 20% of persons with aortic dissection, additional tests may be needed.

Transesophageal echocardiogram (TEE) : A TEE involves inserting a probe into the food pipe near the aorta. Sound waves provide a picture of the heart that the doctor may examine for anomalies.

Aortic angiogram : Aortic angiogram: During this treatment, the doctor will inject a contrast liquid into the arteries. They will next take X-rays to look for any aortic anomalies.

Magnetic resonance angiogram (MRA) : Angiogram using magnetic resonance imaging (MRA). A magnetic field and radio waves are used in this test to examine the blood arteries.
Additional tests, such as blood tests, may help the doctor in ruling out other conditions and situations with similar symptoms.

Treatment

Aortic dissection requires immediate medical attention to avoid complications. Medication, surgery, or both are commonly used in this treatment.

Medications : People with type B aortic dissection may be given beta-blockers and nitroprusside to lower their heart rate and blood pressure and prevent the tear from worsening. People with type A aortic dissection may also take these drugs to help stabilise their condition, although surgery to repair the tear is usually required. Most patients with aortic dissection must take blood pressure drugs for the rest of their lives.
Surgery : Surgery is usually performed on people who have type A aortic dissection to remove the damaged segment of the aorta and replace it with a tube. This technique stops blood from entering the aortic wall. If the aortic valve is leaking, the surgeon will replace it as well. People suffering from type B aortic dissection may go through a similar process, but their operation may also include the insertion of stents, which are thin mesh tubes used to reconstruct the aorta.
Follow-up treatment : Patients may require frequent imaging scans to monitor their condition.

Do’s and Don’ts

It may take some time to restore energy after an aortic dissection. However, patients should maintain a healthy lifestyle and take preventative measures while the aorta is being monitored. These dos and don'ts also apply to individuals who have had aortic dissection surgery.

Do’s	Don’ts
Maintain a healthy blood pressure	Push, pull, bear down or lift anything heavy
Maintain healthy body weight.	Smoke or use any other tobacco products
Do mild to moderate physical activity regularly.	Participate in rigorous, competitive, or contact sports.
Follow up with the doctor regularly to monitor overall health.	Eat high-salt diet
Wear a seatbelt in the vehicle	Eat saturated fats and junk foods

By following the dos and don’ts for aortic dissection manage the symptoms and lead a healthy life. Seek timely treatment and follow up with your doctor to better monitor your condition.