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)

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

Certain steps patients can follow to reduce the progress of increasing size of aneurysm and their risk of rupture. It is important to

• Keep blood pressure under control
• Avoid or quit smoking
• Exercise regularly
• Lower cholesterol and fat
• Regular surveillance