Aortic dissection : Causes - Symptoms- Diagnosis -Treatment

 What is Aortic dissection?

Aorta dissection may be a tear within the inner layer of a weakened space of your artery. Your artery is the main artery that delivers oxygen- and nutrient-rich blood from your heart to the remainder of your body. Aortic dissection may be a critical condition that needs immediate recognition. Treatment includes many kinds of surgery and drugs.

Your artery is the main artery that carries oxygen-rich blood off from your heart to the remainder of your body. The wall of your artery is formed from 3 tissue layers — AN inner layer (intima), middle layer (media) and outer layer (adventitia).

What is Aortic dissection?
Aortic dissection

An aortic dissection begins short once a tear happens within the inner layer of a weakened space of your artery. Blood surges through the tear, inflicting the inner and middle layers to separate (“dissect”). As pleased blood flows between the tissue layers, the traditional blood flow to elements of your body is also slowed or stopped, or the artery could rupture utterly.

Aortic dissection may be a critical condition which will cause overtime if it's not recognized and quickly treated.

  1. Circulatory system

    1. Heart

    2. Arteries

    3. Veins

    4. Capillaries

Medical terms

  • Aortic dissection is a condition in which a tear in the inner wall of the aorta causes the blood to flow between the layers of the artery wall. This can cause the artery to weaken and enlarge, leading to a life-threatening medical emergency. The tear can occur as a result of a trauma, underlying medical conditions, or extended high blood pressure. The condition requires immediate medical attention, as it can lead to aortic rupture and significant internal bleeding.

  • An artery dissection may be a serious condition within which a tear happens within the inner layer of the body's main artery (aorta). Blood rushes through the tear, inflicting the inner and middle layers of the artery to separate (dissect). If the blood goes through the skin artery wall, artery dissection is commonly deadly.

  • Aortic dissection is comparatively uncommon. It always happens to men in their 60s and 70s. Symptoms of artery dissection could mimic those of different diseases, usually resulting in delays in designation. However, once associated artery dissection is detected early and treated promptly, the possibility of survival greatly improves.

  • is a Aortic dissection is a life-threatening condition in which the inner and middle layers of the aorta the main blood vessel that carries oxygenated blood from the heart to all areas of the body separate and fill with blood The outer layer (called an intima) remains intact As this occurs it creates one or more areas where blood can flow between these layers This can lead to significant damage if not quickly diagnosed and treated by a physician Left untreated it often results in death; however prompt medical treatment may save your life Aortic dissection usually happens without warning

  • symptoms Aortic dissection symptoms - an aortic dissection is a very dangerous condition at its onset Patients that experience Aortic Dissection typically have either chest pain or they will present with back pain While this can be indicative of other conditions the most important thing to remember is that when it comes to Aortic Dissection it doesn't matter where one feels the pain what matters is the location of the pain within the chest and torso area The reason for this is because both areas are connected to the central artery which is located in between them: An aorta dissection causes a tear in.

Symptoms Aortic dissection

Typically, harrowing external organ or interscapular pain, usually delineated as tearing or cacophonic, happens short. The pain migrates from the initial location because the dissection extends on the arteria. Up to twenty of patients are diagnosed with syncope thanks to severe pain, arterial blood vessel sensory receptor activation, extracranial artery obstruction, or tamponade. cardiovascular disease and arrhythmia might indicate active hemorrhage.

Occasionally, patients gift with symptoms of malperfusion (stroke, MI, viscus infarct, nephrosis, paresis, or paraplegia) thanks to interruption of the blood provide to a specific vascular bed, together with the funiculus, brain, heart, kidneys, intestine, or extremities. The interruption in blood supply is most frequently thanks to acute distal blood vessel obstruction by the false lumen.

About two hundredth of patients have partial or complete deficits of major blood vessel pulses, which can wax and wane. Limb blood pressures could disagree, typically by > thirty millimeter Hg; this finding suggests a poor prognosis. A murmur of arterial blood vessel regurgitation is detected in regarding five hundredths of patients with proximal dissection. Peripheral signs of arterial blood vessel regurgitation could also be a gift. Rarely, coronary failure results from severe acute arterial blood vessel regurgitation. escape of blood or inflammatory bodily fluid fluid into the left space could cause signs of serous membrane effusion. Occlusion of a limb artery could cause signs of peripheral ischaemia or pathology. artery occlusion could cause oliguria or unwellness. tamponade could cause pulsus paradoxus and jugular blood vessel distention.

Aortic dissection symptoms may be similar to those of other heart problems, such as a heart attack. Typical signs and symptoms include:

  • Sudden severe chest or upper back pain, often described as a tearing or ripping sensation, that spreads to the neck or down the back

  • Sudden severe stomach pain

  • Loss of consciousness

  • Shortness of breath

  • Symptoms similar to those of a stroke, including sudden vision problems, difficulty speaking, and weakness or loss of movement (paralysis) on one side of your body

  • Weak pulse in one arm or thigh compared with the other

  • Leg pain

  • Difficulty walking

When to see a doctor

If you have severe chest pain, fainting, sudden shortness of breath or symptoms of a stroke, call 911 or your local emergency number. These signs and symptoms aren't always due to a serious problem, but it's best to be seen by a doctor quickly. Early detection and treatment may help save your life.

Causes Aortic dissection

Aortic dissection happens as a result of their associated underlying, slow breakdown of the cells that form up the walls of your arteries. The breakdown has possibly been occurring wordlessly for several years before the weakened space of the arterial blood vessel wall finally provides a method, leading to a tear that ends up in the arterial blood vessel dissection.

Why will the arterial blood vessel wall weaken in some individuals, not others? It’s believed that the majority arterial blood vessel dissections square measure caused by an underlying vulnerability that will be hereditary. In others, the strain to the arterial blood vessel wall from constant high vital signs will weaken the arteries including prone individuals, leading to a tear and dissection.

Aortic dissection within the aorta (the section nearest to the center wherever the pressure is that is the highest) is sort of double a lot more common than those who occur within the aorta. Tears within the arteria usually occur in areas wherever the strain on the wall of the arteria is highest.

An artery dissection is caused by a weakened space of the aorta's wall.

Aortic dissections square measure divided into 2 teams, looking on that a part of the artery is affected:

  • Type A. This a lot of common and dangerous sort involves a tear within a part of the arterial blood vessel wherever it exits the guts. The tear may additionally occur within the higher arterial blood vessel (ascending aorta), which can extend into the abdomen. 

  • Type B. This type involves a tear in the lower aorta only (descending aorta), which may also extend into the abdomen.

Risk factors Aortic dissection

Some of the things that may raise your risk of aortic dissection include:

  • Uncontrolled high blood pressure (hypertension)

  • Hardening of the arteries (atherosclerosis)

  • Weakened and bulging artery (aortic aneurysm)

  • An aortic valve defect (bicuspid aortic valve)

  • A narrowing of the aorta at birth (aortic coarctation)

Certain genetic diseases increase the risk of having an aortic dissection, including:

  • Turner syndrome. High blood pressure, heart problems and other health conditions may result from this disorder.

  • Marfan syndrome. This is a condition within which animal tissue, that supports varied structures within the body, is weak. individuals with this disorder usually have a case history of aneurysms of the arteries and alternative blood vessels or case history of artery dissections. 

  • Other connective tissue disorders. This includes Ehlers-Danlos syndrome, a bunch of animal tissue disorders that involve loose joints and fragile blood vessels and Loeys-Dietz syndrome, that causes twisted arteries, particularly within the neck.
    Inflammation of the arteries (giant cell arteritis) may increase your risk of arterial blood vessel dissection.

    Other potential risk factors for arterial blood vessel dissection include: 

  • Sex. Men are more likely to have aortic dissection than women.

  • Age. Aortic dissection is more likely in people aged 60 and older.

  • Cocaine use. This drug temporarily raises blood pressure.

  • Pregnancy. Infrequently, aortic dissections occur in otherwise healthy women during pregnancy.

  • High-intensity weightlifting. This and other strenuous resistance training may raise your risk of aortic dissection by increasing blood pressure during the activity.

Complications Aortic dissection

Possible complications of aortic dissection include:

  • Death due to severe internal bleeding

  • Organ damage, such as kidney failure or life-threatening intestinal damage

  • Stroke

  • Aortic valve damage (aortic regurgitation) or rupture into the lining around the heart (cardiac tamponade)

Prevention Aortic dissection

You can reduce your risk of an aortic dissection by preventing chest injury and taking steps to keep your heart healthy.

  • Control blood pressure. If you have high blood pressure, get a home blood pressure measuring device to help you monitor your blood pressure.

  • Don't smoke. If you do smoke, take steps to stop.

  • Maintain an ideal weight. Follow a low-salt diet with plenty of fruits, vegetables and whole grains and exercise regularly.

  • Wear a seatbelt. This reduces the risk of chest injury during a car accident.

  • Work with your doctor. If you've got a case history of aortic dissection, an animal tissue disorder or a bicuspid semilunar valve, tell your doctor. If you've got an associated aneurysm, verify however usually you would like observance and if surgery is critical to repair your cardiovascular disease.
    If you've got a genetic condition that will increase your risk of aortic dissection, your doctor might advocate medications, although your pressure level is traditional.

How long can you live with aortic dissection?

Aortic dissection is a tear in the inner layer of an artery that causes blood from the heart to flow into layers of the wall This blockage can possibly lead to stroke lung collapse or death within minutes if it isn’t treated promptly Most people who have aortic dissection are over age 60 and are male People at risk for developing this condition include those with high blood pressure sleep apnea and Marfan syndrome according to Mayo Clinic Most people with dissection live 5 years after their diagnosis However depending on your overall health treatment options may increase your life expectancy by.

Can you survive an aortic dissection without surgery?

An aortic dissection is the tearing of the inner wall of the aorta the main artery that carries blood away from the heart to the rest of your body As the tear grows larger it can snap and cause a catastrophic bleed that leads to sudden death Surgery is required in order to fix an aortic dissection but some patients are able to survive without surgical intervention if they get care right away.

What is the treatment of acute aortic dissection?

The treatment of acute aortic dissection is to relieve the obstruction in the descending aorta This involves temporary balloon support of either the subclavian artery or distal abdominal aorta and surgical replacement with an artificial graft; generally type III or IV when the ascending aorta is involved

Can you live a normal life after an aortic dissection?

Aortic dissection is a condition in which the inner wall of your aorta the large blood vessel that carries blood from your heart to your body tears When this happens blood from your heart can spill into the space between the two layers of the aorta's wall and then leak back into the bloodstream This process can create severe pain; if left untreated it could be fatal Most dissection patients survive with treatment because their bodies are able to seal off most tears before they become too large; however some develop complications or die from related conditions like pulmonary embolism stroke or organ failure.

Aortic dissection is a heart condition in which there is an abnormal separation of the inner layers of the aorta This can lead to life-threatening blood loss as well as damage to the heart and surrounding blood vessels The symptoms of have typically been described as " tearing" or " ripping" sensations in the back just below the ribs or both These are also known as back pain that occurs on either side at or near upper abdomen or between your shoulder blades Additionally ,you may experience dizziness and weakness shortness of breath and nausea.

Diagnosis Aortic dissection

Aortic dissection should be thought-about in any patient with hurting, pectoral back pain, unexplained syncope, unexplained abdominal pain, stroke, or acute-onset cardiomyopathy, particularly once pulses or blood pressures within the limbs area unit are unequal. Such patients need a chest x-ray; in sixty to ninetieth, the mediastinal shadow is widened, sometimes with a localized bulge signifying the location of origin. Left serosal effusion is common.

Patients presenting with acute hurting, diagnostic procedure (ECG) changes of acute inferior infarct, and a antecedently undocumented murmur of arterial insufficiency (AI) area unit of specific concern for a sort I arteria dissection into the correct arterial blood vessel (causing inferior heart muscle infarction), and also the semilunar valve (causing AI).

If chest x-ray suggests dissection, TEE, CTA, or MRA is completed directly when the patient is stabilized. Findings of Associate in Nursing membrane flap and double lumina make sure dissection.

Multiplanar TEE is ninety seven to ninety nine sensitive and, with M-mode diagnostic technique, is almost 100 percent specific. It is often done at the side in < twenty minutes and doesn't need distinction agents. However, CTA is typically} the first-line imaging modality as a result of it's often out there earlier and wider than TEE. The sensitivity of CTA exceeds ninety fifth and it's a positive prophetic worth of 100 percent and a negative prophetic worth of eighty six.

MRA has nearly 100 percent sensitivity and specificity for arterial dissection. however it's long and ill-suited for emergencies. It's most likely best used for stable patients with acute or chronic hurting once dissection is suspected.

Contrast aortography is Associate in Nursing choice if surgery is being thought-about. Additionally to characterize the origin and extent of dissection, severity of arteria regurgitation, and extent of involvement of the aorta’s major branches, aortography helps confirm whether or not coincident arterial blood vessel bypass surgery is required. diagnostic technique ought to even be done to ascertain for arteria regurgitation and therefore confirm whether or not the semilunar valve ought to be repaired or replaced concomitantly.

Electrocardiography (ECG) is almost universally done. However, findings vary from traditional to markedly abnormal (in acute arterial blood vessel occlusion or arteria regurgitation), therefore the take a look at isn't diagnostically useful for dissection itself. Assays for soluble albuminoid compounds and smooth-muscle globulin heavy-chain macromolecule area unit being studied; the information seems promising, however the assays aren't habitually out there. bodily fluid amino alkanoic acid kinase-MB and troponin levels could facilitate distinguishing arterial dissection from infarct, except once dissection causes infarct.

Routine laboratory tests could find slight leukocytosis and anemia if blood has leaked from the artery. inflated bottle-feed dehydrogenase could also be a nonspecific sign of celiac or peritoneum blood vessel trunk involvement.

Detecting an aortic dissection can be a challenge because the symptoms are similar to those of many other health problems. Your doctor may think you have an aortic dissection if you have:

  • Sudden tearing or ripping chest pain

  • Blood pressure difference between the right and left arms

  • Widening of the aorta on chest X-ray

Tests to diagnose aortic dissection include:

  • Transesophageal echocardiogram (TEE). This test uses sound waves to create pictures of the heart in motion. A TEE is a special type of echocardiogram in which an ultrasound probe (transducer) is guided through your esophagus and placed close to your heart. This test gives your doctor a clearer picture of your heart and aorta than would a regular echocardiogram.

  • Computerized tomography (CT) scan of the chest. X-ray are used to produce cross-sectional images of the body. A CT of the chest can confirm a diagnosis of aortic dissection.

  • Magnetic resonance angiogram (MRA). An MRA uses a magnetic field and radio wave energy to create images of your blood vessels.

Treatment Aortic dissection

An aortic dissection is a medical emergency requiring immediate treatment. Treatment may include surgery or medications, depending on the area of the aorta involved.

Type A aortic dissection

Treatment for type A aortic dissection may include:

  • Surgery. Surgeons take away the maximum amount of the compound arterial blood vessel as potential and stop blood from unseaworthy into the aortic wall. an artificial tube (graft) is employed to reconstruct the arterial blood vessel. If the semilunar valve leaks as a result of the broken arterial blood vessel, it should get replaced at an equivalent time. The new valve is placed at intervals the graft. 

  • Medications. Medications square measure given to cut back vital signs and lower pressure, which may stop the arterial blood vessel dissection from worsening. they'll tend to folks with type A arterial blood vessel dissection to manage pressure before surgery. 

Type B aortic dissection

Treatment of type B aortic dissection may include:

  • Medications. The same medications that are used to treat type A aortic dissection may be used without surgery to treat type B aortic dissections.

  • Surgery. The procedure is analogous thereto accustomed to correct a sort A artery dissection. generally stents — little wire mesh tubes that act as a form of system — are also placed within the arterial blood vessel to repair difficult blood type artery dissections.
    After treatment, you will have to be compelled to take medication to regulate your pressure level for the remainder of your life. you will want regular CT scans or MRI scans to observe your condition. 

What will my life look like if I have aortic dissection?

Every person WHO survives arteria dissection — albeit they didn’t have surgery — must be seen at regular intervals (usually each 3 to twelve months) for follow-up imaging. Imaging permits changes to be caught which will then be acted upon in an exceedingly safe and timely manner.

Blood pressure drugs, typically beta-blockers, are going to be prescribed to manage your pressure level and vital signs. You’ll have to be compelled to take them for the remainder of your life. Typically over one pressure level medication is also required. If you can’t tolerate these medications, alternative pressure level medicine will be used.

Aerobic exercises — like walking, biking and swimming — are also inspired. however you’ll have to be compelled to avoid activities, like significant weight lifting , which might increase pressure level and place more stress on your arteries. 

General summary

  1. Aortic dissection a medical emergency in which the inner wall of the aorta tears causing symptoms ranging from mild chest pain to sudden death If an individual has a very high risk for an aortic dissection doctors sometimes recommend surgery This procedure involves reconnecting the two parts of the torn artery by inflating an expandable tube called a stent into place inside it The stent is left permanently in place and appears to help keep the tear from widening In addition many physicians prescribe blood pressure-lowering drugs such as beta blockers or calcium channel blockers for people who have had an aortic.

  2. Aortic dissection is a life threatening condition that occurs when there is a tear in the innermost layer of the aortic wall. This tear causes blood to flow between the layers of the wall and can lead to aortic rupture, heart failure, and stroke. As a result, urgent medical attention is necessary when a person is suspected to have aortic dissection. Early diagnosis is essential in order to increase the chances of successful treatment and reduce the risk of further complications.

  3. Aortic dissection is a life-threatening condition that occurs when the inner wall of the aorta, the largest and most important artery in the body, tears. This tear allows blood to enter the aortic wall, which causes it to weaken and expand. If left untreated, aortic dissection can lead to complete blockage of the aorta, leading to stroke, heart attack, sepsis, and possibly death. It is important to recognize the symptoms of aortic dissection early on in order to prevent serious complications.

  4. Aortic dissection is a medical emergency that requires prompt diagnosis and treatment. It occurs when a tear in the inner layer of the aorta causes blood to be displaced from one layer of the wall to the other, resulting in a separation of the layers. This can lead to an aneurysm or rupture in the wall, which can be fatal if not treated quickly. In the United States, it is estimated that approximately 10,000 people suffer from aortic dissection each year.

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