As the name suggests, aortic dissection occurs when the inner layer of the aorta, the main artery carrying blood from the heart to the rest of the body, tears and separates from the outer layer. As a result, blood can flow through a false channel, causing further damage to the aorta. Aortic dissection can result in life-threatening complications including organ failure, bleeding, heart attacks and stroke.
Aortic dissection is not fully understood, but it is frequently associated with high blood pressure, which can weaken the aortic wall over time. Other risk factors include:
Age: Aortic dissection is more common in people over 60 years old.
Gender: Men are more likely to develop aortic dissection than women.
Genetics: Some inherited conditions, such as Marfan syndrome or Ehlers-Danlos syndrome, can affect the structure and strength of the aorta and make it more prone to dissection.
Atherosclerosis: This is a condition where fatty deposits build up in the arteries and narrow them, reducing blood flow and increasing pressure.
Trauma: A severe injury to the chest or abdomen, such as from a car accident or a fall, can damage the aorta and cause a tear.
Pregnancy: The hormonal changes and increased blood volume during pregnancy can put extra stress on the aorta, especially in women with pre-existing conditions that affect the aorta.
Cocaine use: Cocaine can cause a sudden spike in blood pressure and damage the aorta.
According to the location and extent of the tear, aortic dissection can cause a variety of symptoms. Symptoms include severe chest pain that occurs suddenly, often referred to as tearing, ripping, or shearing. Pain may radiate to the back, neck, jaw, or abdomen. Other symptoms include:
Shortness of breath
Difficulty swallowing
Dizziness or fainting
Sweating or clamminess
Nausea or vomiting
Weakness or numbness in one or both arms or legs
Unequal pulses or blood pressure in different limbs
Loss of consciousness
You should contact 911 or go to the nearest hospital if you experience any of the symptoms mentioned above. Aortic dissection can be diagnosed by a combination of your medical history, physical examination, and imaging tests.
Chest X-ray: This can show the shape and size of the aorta and detect any abnormalities or widening.
Using sound waves, an echocardiogram creates an image of the heart and aorta and shows the extent of the dissection, as well as any damage to the heart valves or chambers.
A computed tomography (CT) scan uses X-rays to create detailed images of the chest and abdomen that can identify the precise location and size of the tear, as well as any organ or blood vessel involvement.
A magnetic resonance imaging (MRI) scan uses magnets and radio waves to create images of the chest and abdomen that provide more detail and clarity than a CT scan.
Angiography: This involves injecting a dye into the bloodstream and taking X-rays to show the blood flow and any blockages or leaks in the aorta or its branches.
Treatment for aortic dissection depends on the type, location, and severity of the tear, as well as the patient's overall health and preferences. A major goal of treatment is to prevent the dissection from getting worse, restore normal blood flow, and prevent complications. Treatment options include:
Aortic dissections, especially type B dissections that do not involve the first part of the aorta near the heart, are usually treated with medication first. As well as reducing blood pressure and heart rate, medication can also reduce inflammation and pain. Beta blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, and painkillers are commonly used to treat aortic dissection.
A type A dissection that involves the first part of the aorta near the heart, as well as a type B dissection that causes complications, such as organ damage, bleeding, or infection, is often treated with surgery. An aorta tear can be repaired or replaced with a synthetic graft, or a stent-graft can be implanted into the aorta to seal the tear and restore blood flow with surgery. The procedure can be performed via an open chest or abdominal incision, or through a less invasive endovascular approach through a small cut in the groin.
Aorta monitoring and follow-up: To detect signs of recurrence or complications, regular check-ups and imaging tests are necessary after treatment. It is also possible to prevent further damage to the aorta and improve overall health and quality of life by making lifestyle changes, such as quitting smoking, controlling blood pressure and cholesterol, eating a healthy diet, and exercising regularly.
Aortic dissection is not always preventable, but there are some steps you can take to reduce your risk, such as:
Know your family history and get screened for any inherited conditions that affect the aorta, such as Marfan syndrome or Ehlers-Danlos syndrome.
Monitor and control your blood pressure and cholesterol levels, and take medication as prescribed by your doctor.
Quit smoking and avoid using cocaine or other illicit drugs that can harm the aorta.
Maintain a healthy weight and eat a balanced diet that is low in fat, salt, and sugar, and high in fiber, fruits, and vegetables.
Exercise regularly and moderately, and avoid strenuous or sudden physical activities that can increase the pressure on the aorta.
Manage your stress and practice relaxation techniques, such as meditation, yoga, or breathing exercises.
Seek medical attention promptly if you experience any symptoms of aortic dissection, such as severe chest pain, shortness of breath, or fainting.
If you are aware of the causes, symptoms, and risk factors of aortic dissection, you can take steps to protect yourself and your aorta.
