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Aortic dissection Causes and Risks:
Aortic dissection involves bleeding into and along the wall of the aorta (the major artery from the heart), most often because of a tear or damage to the inner wall of the artery. This usually occurs in the thoracic (chest) portion of the aorta but may occur in the abdominal portion also.
The exact cause is unknown, but risks include atherosclerosis and hypertension . Traumatic injury is a major cause of aortic dissection, especially blunt trauma to the chest as with the steering wheel of a car during an accident. Aortic dissection may also be associated with other injury, infection, congenital weakness of the aorta, collagen disorders such as Marfan's syndrome , pseudoxanthoma
elastoma, Ehlers-Danlos syndrome, relapsing polychondritis, or abdominal aortic aneurysm . Pregnancy , valve disorders (including aortic insufficiency ), and coarctation of the aorta may also be associated with aortic dissection.
Aortic dissection occurs in approximately 2 out of 10,000 people. It can affect anybody, but it is most often seen in men 40 to 70 years old.
Prevention:
Adequate treatment and control of atherosclerosis and hypertension may reduce risk. Use safety precautions to reduce the risk of injury. Many cases are not preventable.
Symptoms:
- chest pain
- sudden, severe
- sharp, stabbing, tearing, or ripping
- located below the sternum, under the shoulder blades, or in the back
- pain may radiate to shoulder, neck, arm, jaw, abdomen, hips
- location of pain may change
- changes in thought ability, concentration ( confusion , disorientation)
- decreased movement, any location
- decreased sensation , any location
- anxiety
- pallor
- rapid pulse ( heart rate )
- profuse sweating
- dry skin/mouth , thirst
- nausea , vomiting
- dizziness , fainting
- shortness of breath ( dyspnea )
Note: Symptoms may begin suddenly.
Additional symptoms that may be associated with this disease:
Signs and Tests:
Listening with a stethoscope ( auscultation ) at the chest and abdomen may reveal a "blowing" murmur over the aorta, a heart murmur, or other abnormality. There may be decreased (weak) pulses in the upper extremities. There may be signs of tamponade or hypovolemia , or signs resembling acute MI . There may be signs of shock but with normal blood pressure .
Aortic dissection or aortic aneurysm may be revealed on:
Treatment:
The goal of treatment is prevention of complications. Hospitalization is usually required.
Antihypertensives may be prescribed to reduce blood pressure . These may be given through a vein ( intravenous ). Analgesics may be needed for pain. Cardiac medications such as beta-blockers may reduce some of the symptoms.
Surgical repair or replacement of the section of aorta is curative.
Prognosis:
Aortic dissection may be life threatening. The disorder is curable with surgical repair if it is performed before aortic rupture. Less than half of the patients with ruptured aorta survive.
Complications:
Call Your Healthcare Provider:
If symptoms indicate aortic dissection may be present or severe chest pain develops, call the local emergency number (such as 911) or go to the emergency room.
Aortic rupture (a tear in the aorta, which is the major artery coming from the heart) can be seen on a chest X-ray. In this case, it was caused by a traumatic perforation of the thoracic aorta. This is how the X-ray appears when the chest is full of blood (right-sided
hemothorax) seen here as cloudiness on the left side of the picture.
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