heart

Health Talk: Aortic Dissection

What Aortic Dissection Is

Aortic Dissection is a serious type of heart condition wherein a tear is found at the inner layer of the aorta, allowing the blood to surge through it and causing the aorta’s inner and middle layers to dissect or separate. This type of condition can become fatal when the blood-filled channel ruptures through the aorta’s outer wall. This type of condition may seem relatively uncommon and frequently occurs in men in their 60s and 70s.

Aortic dissection may be classified into two groups : Type A – a more common and dangerous type wherein a tear is involved in the part of the aorta and exits the heart or even a tear in the ascending aorta extending to the abdomen and Type B- a type of aortic dissection in which a tear is found only in the descending aorta which may also extend into the abdomen.

Symptoms

Just like any other heart conditions,  symptoms of aortic dissection are sudden severe pain in the chest and back, loss of consciousness, shortness of breath,  difficulty in speaking, loss of vision, weakness or paralysis on one side of the body, weak pulse in one arm and mostly, heart attack.

Causes

A possible cause of aortic dissection is a weakened aortic wall in which the aortic tissue is susceptible to tearing due to stress caused by chronic high blood pressure. Other types of heart conditions such as bicuspid aortic valve, an enlarged aorta, Marfan syndrome and even rare illness associated with weakening of walls in the blood vessels may possibly cause this kind of heart problem. Aortic dissection is rarely caused by traumatic chest injuries, most especially brought about by motor vehicle accidents.

Risk Factors

Possible risk factors for this type of heart condition include atherosclerosis (hardening of arteries) , hypertension, bicuspid aortic valve, aortic coarctation (narrowing of aorta) , and pre-existing aortic aneurysm.

These risks are increased by certain genetic diseases like Marfan syndrome, Turner’s syndrome, inflammatory or infectious conditions and other connective tissue disorders (e.g. Ehlers-Danlos syndrome –a disease in which a group of connective tissue disorders are characterized by skin that is easily bruised or teared, fragile blood vessels and loose joints.)

Other potential risk factors for aortic dissection involve high-intensity weightlifting, cocaine use, pregnancy, sex and age.

Complications

When not treated properly,  this type of heart condition may lead to complications such as organ damage (e.g. kidney failure and life-threatening intestinal damage) , stroke, aortic valve damage (aortic regurgitation) /rupture into the heart’s lining (cardiac tamponade) , stroke and worse, death due to severe internal bleeding.

Treatments and Drugs

Treatment for aortic dissection include surgery and medications, depending on its type or classification. For Type A aortic dissection , much of the dissected aorta is removed by surgeons in order to block the entry of blood through the aortic wall and reconstruct the aorta with a graft. The aortic valve may be replaced at the same time , should a leak occur in the aortic valve as a result of a damaged aorta. As for the medication, beta-blockers and Nitropress may be taken to reduce the heart rate and lower the blood pressure, in order to prevent worsening of aortic dissection. These medications are used for patients with Type A aortic dissection so as to stabilize blood pressure before establishing a surgical operation.

For Type B aortic dissection, on the other hand, a type of surgery done is somehow similar with that of Type A aortic dissection, only that sometimes small wireless tubes called stents which act as scaffolding are being used or placed in the aorta to repair this complicated type of condition. However, the medications used in treating Type A aortic dissections may also be used  to treat patients with Type B aortic dissection without performing any surgery.

After the treatment, patients with this type of condition  are required to take blood pressure lowering medication for their entire life and have follow up CT scans or MRIs in order to monitor their illness.

Prevention

To further reduce or prevent the risk of aortic dissection, patients should coordinate with their doctor, control their blood pressure, maintain an ideal weight, wear seat belt (for safety purposes),  and avoid smoking.

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