Aortic Dissection: Symptoms, Causes, Diagnosis and Treatment

aortic dissection

Aortic dissection is actually a tear in the aortic wall which leads to blood flow between the layers of the aortic wall and it draws the layers of the aorta apart. Aortic dissection is an emergency condition which can result in death that too very quickly, even after the best possible treatment. If the dissection ruptures the aorta completely then it leads to immense and rapid blood loss. The mortality of this condition is very high, and in some case the patients pass away before they reach the infirmary.

Symptoms 

The symptoms of aortic  dissection usually occurs abruptly, with severe chest pain. The patient in this condition usually experience a sharp, stabbing, tearing, or ripping chest pain. This takes place below the chest bone and pass to the back or under the shoulder blades. This pain also moves to the shoulder, arm, abdomen, or hips, neck and jaw.
 
Some of other symptoms of aortic dissection includes dizziness, dryness of mouth, fainting, nausea and vomiting, Changes in thought ability, disorientation which leads to confusion and mental instability, profuse sweating, rapid or very weak pulse, and difficulty in breathing. 

Causes and Risk Factors

The aortic dissection usually takes place in the thoracic area of the artery, but sometimes it occurs in the abdominal region too. And this condition is classified as type A or B depending on their location. In type A, the pain begins from ascending part of the aorta, and the pain occurs in the descending part of the aorta in type B aortic dissection. This condition is life-threatening health complication which leads to abnormal ballooning or widening of the aorta which is known as aneurysm. The exact cause is unknown, but risks include atherosclerosis that is hardening of the arteries and high blood pressure. Traumatic injury is also believed to be the main cause for aortic dissection, that too particularly blunt trauma. The other complicated conditions and risk factors linked with the cause of aortic dissection include bicuspid aortic valve, connective tissue disorders, pseudoxanthoma elasticum, aging, Ehlers-Danlos syndrome, heart surgeries, Marfan syndrome and vascular inflammation caused by arteritis and syphilis.

Diagnosis

The  basic and fundamental diagnostic procedures are family history and listening to the abnormal sound from your heart, lungs, and abdomen using a stethoscope. A person with the condition has a difference in the blood pressure reading in their right and left arms.
Aortic aneurysm or aortic dissection is also diagnosed through aortic angiography, chest x-ray, chest MRI, CT scan of the chest using a dye, doppler ultrasonography, echocardiogram and transesophageal echocardiogram (TEE).

Treatment 

Actually the goal of treatment in this condition is to prevent the complications. As it is an emergency condition, hospitalization is a must.

Type A aortic dissections demand immediate surgery to fix the aorta. Type B aortic dissections can be treated using medications first or bringing in a stent into the descending aorta. Usually medications that lower blood pressure and strong pain relievers are prescribed. Heart disease medications like beta-blockers are also helpful to reduce the symptoms of aortic dissection. If the aortic valve is injured completely, then valve replacement surgery is necessary. If it involves heart arteries then coronary bypass surgery is an only solution.   

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