Aortic Dissection
An aortic dissection is a serious life threatening condition in which the inner layer of the aorta, the large blood vessel branching off the heart, tears and splits open.
Causes
High blood pressure
Atherosclerosis
Smoking
Genetic conditions eg Marfan syndrome
Injury
Aortic valve defect
Idiopathic(Unknown)
Symptoms
Similar to other heart problems. Hence it is sometimes diagnosed late.
- Sudden severe chest or upper back pain, often described as a tearing, ripping or shearing sensation, that radiates to the neck or down the back
- Sudden severe abdominal pain
- Loss of consciousness
- Shortness of breath
- Sudden difficulty speaking, loss of vision, weakness or paralysis of one side of your body, similar to those of a stroke
- Weak pulse in one arm or thigh compared with the other
- Leg pain
- Difficulty walking
- Leg paralysis
Diagnosis
A portion of the affected aorta is detected in a ECHO scan of an ultrasound scan done suspecting other diagnosis. This leads to a more definitive investigation called a CT scan(angiogram).
CT angiogram helps to confirm diagnosis and helps to decide therapy needed based on extent of disease.
Treatment
Medications
To reduce heart rate and lower blood pressure, which can prevent the aortic dissection from worsening. Most patients require medications only
Surgery
Surgeons remove as much of the dissected aorta as possible, block the entry of blood into the aortic wall and reconstruct the aorta with a synthetic tube called a graft.
Thoracic endovascular aortic repair (TEVAR)
Minimally invasive method
Small surgical cut in the groin of a small hole based treatment
A device called stent-graft made of a fabric-covered metal mesh used to fix or “re-line” the aorta.
It avoids blood flow to the diseased aorta and helps to keep it open and allow blood to flow properly to the rest of the body.
Prevention
- Control blood pressure
- Don’t smoke.
- Maintain an ideal weight..
- Wear a seat belt. This reduces the risk of traumatic injury to your chest area.
- Consult your doctor if your immediate family member has suffered an aortic dissection and a genetic cause is suspected