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Aortic Dissections

Updated: Sep 18, 2023


An aortic dissection is a tear through part but not all layers of the aortic wall. The aortic wall is made of three layers. A dissection involves a tear in the inside layer (Intima) and blood travels in the middle layer (Media) and is held inside by the outside layer (Adventitia). The diagram below shows the three layers in cross section and a representative illustration of what occurs when blood seeps through the layers of the aorta during a dissection.


An aortic dissection is thus very serious. The dissection may disrupt blood flow to the heart, brain, limbs, organs or any part of the body, which will also then be affected. The initial tear in the inner layer can occur from just above the heart, or anywhere along the entire length of the aorta, to near the top of the legs.


Type A Dissection

If the tear in the lining is in the first part of the aorta near where it exits the heart, or in the arch, this is called a Type A dissection.


Type B Dissection

If the tear is in the descending part of the aorta, beyond where the artery that goes down the left arm branches off, this is called a Type B dissection.


Risk factors

There are various risk factors for aortic dissection, including general health risk factors and genetic risk factors. These include having an aneurysm, high blood pressure, bicuspid aortic valve, illicit drug use, atherosclerosis such as cocaine, weight lifting and other sports high intensity or heavy contact sports, pregnancy, genetic risk factors including connective tissue diseases like Marfan, Loeys-Dietz, and Ehlers-Danlos, Turner, and Bicuspid Aortic Valve syndrome.


Typical signs and symptoms:

When the aorta dissects, it causes a very sudden and intense pain. The pain may occur anywhere from the chest area up towards the head, neck and jaw, down the back and/or into the abdomen, arms or legs, depending which portion of the aorta is involved. Other signs and symptoms include loss of consciousness, difficulty walking, weak pulses in hands or feet.

The pain can feel like a heart attack. In a minority of cases, a dissection can cause very little pain.


An aortic dissection is therefore a medical emergency and will present with a sudden, sharp pain in the upper back that travels to the back and downwards, sudden drop in blood pressure and dizziness / loss of consciousness.


Complications:

The complications due to an aortic dissection can be quite severe. This includes death due to severe internal bleeding, organ damage such as kidney failure or life-threatening intestinal damage, aortic valve damage (aortic regurgitation) or rupture into the tissue that surrounds the heart (cardiac tamponade).


Overall, if you have a known aneurysm or are at high-risk for having an aortic dissection please discuss your concerns and potential screening options.


And that’s what we have today for you all about aortic dissections.

Please check out the Patient Guide at https://t.co/An7aDzdQ7z and refer to pages 13-25 for a more comprehensive summary of today's post.


Thanks for tuning in and join us back here on Monday as we discuss Aortic Valves.


Have a wonderful weekend and stay healthy.

Duc




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