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Aortic Dissection

Aortic Dissection

An aortic dissection is a serious medical emergency that occurs when a tear forms in the inner layer of the aorta, the main artery that carries blood away from the heart to the rest of the body. This tear allows blood to flow between the layers of the aortic wall, separating them and weakening the aorta. If the dissection weakens the aorta enough, it can rupture, causing life-threatening bleeding.

Causes

Aortic dissection can be caused by several factors, including:

  • High blood pressure: This is the most common cause of aortic dissection. Uncontrolled high blood pressure can weaken the aortic wall over time, making it more susceptible to tearing.
  • Atherosclerosis: This is a condition in which fatty deposits build up in the walls of the arteries. Atherosclerosis can narrow the aorta and make it more likely to tear.
  • Certain medical conditions: Conditions such as Marfan syndrome, Ehlers-Danlos syndrome, and Turner syndrome can weaken the connective tissues in the body, including those in the aortic wall.
  • Trauma: Aortic dissection can be caused by blunt chest trauma, such as a car accident or a fall.
  • Certain medications: Certain medications, such as cocaine and amphetamines, can increase the risk of aortic dissection.

 

Symptoms

The symptoms of aortic dissection can vary depending on the location and severity of the dissection. However, some common symptoms include:

  • Sudden, severe chest pain that may radiate to the back, neck, or jaw
  • Sharp pain between the shoulder blades
  • Shortness of breath
  • Sweating
  • Nausea and vomiting
  • Rapid heart rate
  • Loss of consciousness (in severe cases)

It is important to note that not everyone with aortic dissection will experience all of these symptoms. If you are experiencing any of these symptoms, it is important to seek medical attention immediately.

 

Diagnosis

Aortic dissection can be diagnosed using a variety of imaging tests, such as:

  • Chest X-ray: This test can show widening of the mediastinum (the area in the chest between the lungs).
  • Electrocardiogram (ECG): This test can show changes in the heart’s electrical activity that may be caused by aortic dissection.
  • Echocardiogram: This test uses sound waves to create images of the heart and aorta.
  • Computed tomography (CT) scan: This test can provide detailed images of the aorta and surrounding structures.
  • Magnetic resonance imaging (MRI) scan: This test can also provide detailed images of the aorta and surrounding structures.

 

Treatment

The treatment for aortic dissection depends on the location and severity of the dissection. In some cases, medication may be used to lower blood pressure and control pain. In other cases, surgery may be necessary to repair the tear in the aorta and prevent rupture.

There are two main types of surgery for aortic dissection:

  • Open surgical repair: This surgery involves making an incision in the chest or abdomen to access the aorta and repair the tear.
  • Endovascular aortic repair (TEVAR): This is a minimally invasive procedure that uses a catheter inserted through an artery in the groin to deliver a stent graft to the aorta. The stent graft helps to seal the tear and prevent further dissection (Click here to read more on Endovascular aortic aneurysm repair (EVAR / ESVG))

Early diagnosis and treatment of aortic dissection are essential for improving the chances of a successful outcome.