The aorta is the main vessel that carries blood from the heart to the rest of the body. Its a wall is made of 3 layers. An aortic dissection is a tear that occurs between the innermost and middle layers of the aorta. Aortic dissections occur in about 3 per 100,000 patients per year. Both men and women are affected. Aortic dissections can compromise blood flow to your heart, brain, kidneys, liver, bowels and limbs. This condition is called mal-perfusion syndrome. Aortic dissections can also cause your aorta to rupture, which may lead to life-threatening bleeding.
Some aortic dissections are asymptomatic and are discovered during screening for other conditions. The most common presentation is chest pain/back pain
- High Blood Pressure
- Genetic/Familial Disorders – Ehlers-Danlos Syndrome, Marfans Syndrome or Loews-Deitz Syndrome
Diagnosis is made via different types of imaging tests. These can include an ultrasound of the heart (an echocardiogram or echo), MRI or CT scan.
Treatment of aortic dissections depends on the type of dissection.
Type A (ascending) dissections involve the aorta in the front of the chest, right next to the heart.
- Emergency treatment is required because a heart attack is possible.
- Usually, treatment is traditional surgery involving opening the chest and repairing and/or replacing the torn aorta.
Type B (descending) dissections occur in the aorta elsewhere in the chest and abdomen.
- If you have no symptoms, you may not need treatment.
- If the dissection is long-standing it may cause an enlargement (aneurysm) of the aorta. Depending on the circumstances, minimally invasive stent-grafts or open surgery can be required.
- If you are experiencing a lack of blood flow to an organ or a limb or bleeding, emergency treatment is needed. Usually, treatment is an endovascular stent graft, a minimally invasive procedure to reline the torn aorta and repair the dissection.
- Have your blood pressure tested regularly
- If you have high blood pressure, follow your doctor’s instructions for managing it
- Avoid the use of recreational drugs
- Stop smoking