Aortic Dissection

Aortic dissection happens when there is a tear in the inner wall of the aorta. The aorta is the largest blood vessel in the body. It carries blood from the heart to the arteries, and those arteries send blood to all parts of the body. When there is a tear, the blood enters inside the aortic wall and creates a new space for the blood. This causes the aorta to split even more. The collection of blood into this new space may lower the amount of blood that reaches the rest of the body. A dissection causes the aortic wall to be weakened and can cause rupture. Death can occur. It is critical to have medical care right away.

CAUSES

Aortic dissection is caused by two things:

  • A small tear that develops in a weak or injured part of the aortic wall.

  • The tear spreads inside the aortic wall and the aorta becomes "double-barreled."

The following increase the risk of aortic dissection:

  • High blood pressure.

  • Hardening of the walls of arteries.

  • Use of cocaine.

  • Blunt injury to the chest.

  • Genetic disorders that affect the connective tissue (one example is Marfan syndrome).

  • Problems (such as infection) that affect either the aorta or the heart valve.

  • Problems that affect the tissue that holds together different parts of your body (connective tissue). For example, a few uncommon arthritis problems can increase the chance of an aortic dissection.

SYMPTOMS

  • Sudden onset of severe chest pain. The pain may be sharp, stabbing, or ripping in nature.

  • The pain may then shift to the shoulder, arm, neck, jaw, abdomen, or hips.

Other symptoms may include:

  • Breathing trouble.

  • Weakness of any part of the body.

  • Decreased feeling of any part of the body.

  • Fainting.

  • Dizziness.

  • Feeling sick to your stomach (nausea) and vomiting.

  • Sweating a lot.

  • Confusion/dazed.

DIAGNOSIS

Testing may include the following:

  • Electrocardiogram.

  • Chest x-ray.

  • Imaging study done after injecting a dye to clearly view the blood vessel (aortic angiography).

  • Specialized x-ray of the chest is done after injecting a dye (CT scan) or an MRI.

  • A test where the image of the heart is studied using sound waves (Echocardiogram).

TREATMENT

Treatment will vary depending on what part of the aorta has the problem. Your caregiver may admit you into an intensive care unit. Medicines that reduce the blood pressure and strong painkillers may be given right away. In many cases, heart medicines may be given to relieve the symptoms and help blood pressure.

If medicines are used first and they do not help, then surgery may be done to repair or replace the damaged portion of the aorta. In some cases, surgery is needed right away. You may have to stay in the hospital for 7-10 days. If the aortic valve is damaged due to aortic dissection, repair or replacement of the valve may be done. If the arteries of the heart are affected, bypass surgery of the heart may be done.

THIS IS AN EMERGENCY. Call your local emergency services (911 in U.S.) right away or the closest medical facility.