|
|
|
|
|
|
|
Aortic Dissection
What
is aortic dissection? Aortic
dissection is a tear or partial tear in the lining of the largest blood
vessel in the body, the aorta. This tear allows blood (and the pressure of
the blood flow) to penetrate the arterial wall. Over time, this continuous
flow can cause the aorta to rupture--a condition that most people do not
survive. There are two
types of aortic dissections, although sometimes both conditions occur:
What
are the warning signs and symptoms of aortic dissection? Aortic
dissections are commonly found in people with high blood pressure,
arteriosclerotic vascular disease, in individuals with a family history of
aortic (or thoracic) dissection and more rarely associated with congenital
cardiovascular disorders (Marfan's syndrome,
Ehlers-Danlos syndrome, and congenital valvular disorders). "Stabbing"
pain in the back is a common symptom of an aortic dissection. In some cases,
people present with pain in the chest. This pain may be confused with angina
(commonly referred to as "chest pain" and a warning sign of a
possible heart attack). The main difference between pain resulting from
dissection of the aorta, and angina due to lack of blood supply to the heart
muscle, is its sudden and intense onset. The pain is characterized as a
"ripping" or "tearing" sensation. This sudden pain can be
felt in the back, chest, neck, or jaw. These are
important differences to understand. Why? Because a common recommendation to
those with angina or "chest pain" (that may result in a heart
attack) is to chew an aspirin to thin the blood. This is NOT the case if you
are experiencing an aortic dissection. Thinning the blood for a person with
aortic dissection may cause more blood to leak out of the aorta. This
internal bleeding can lead to death. In some
cases, people do not experience any pain. Instead, you may experience any of
the following symptoms:
If you or
someone you know is experiencing any of the above symptoms, call 9-1-1
immediately to get to a hospital. The survival rate increases dramatically
the sooner a person is treated for an aortic dissection. How
is an aortic dissection detected? The key to
diagnosing an aortic dissection is to confirm that it is in fact a dissection
and not a heart attack, and which type it is (as the treatment options vary
significantly). The gold
standard for diagnosing aortic dissection is a computed topography (CT) scan.
Other imaging studies may be required to identify the type and location of
the dissection. These include:
What
are the treatment options for an aortic dissection? Three treatment
options exist for an aortic dissection: 1) medical management, 2)
interventional catheterization, and 3) cardiovascular surgery. Depending upon
the location and severity of the dissection, your physician will decide which
option is best for you. A small
percent of cases (5 - 10%) are Type B dissections (dissections of the
descending aorta). This condition can be treated with surgical repair, but it
carries significant risk. Typically, your doctor will monitor the condition
periodically and prescribe medications to control the dissection. The
techniques used to treat dissections are as follows:
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
