Aortic dissection is a serious medical condition involving the aorta, the largest artery in the body. It occurs when a tear in the aorta’s inner layer allows blood to flow between the layers of the aortic wall, causing them to separate (dissect).
Pathophysiology
- Formation of a Tear: Typically begins with a tear in the intima, the inner layer of the aorta.
- Creation of a False Lumen: Blood enters this tear, creating a new pathway between the intima and the media (middle layer).
Risk Factors
- Hypertension: The most significant risk factor.
- Connective Tissue Disorders: Like Marfan Syndrome or Ehlers-Danlos Syndrome.
- Atherosclerosis
- Family History: Genetic predisposition plays a role.
- Lifestyle Factors: Smoking, drug use (especially cocaine), and excessive alcohol consumption.
Types of Aortic Dissection
- Type A: Involves the ascending aorta, more dangerous, requires urgent surgery.
- Type B: Involves the descending aorta, can sometimes be managed medically.
Clinical Presentation
- Sudden Severe Chest or Upper Back Pain: Often described as tearing or ripping.
- Symptom Variability: Depending on the extent and location of the dissection.
- Stroke, Paralysis, or Limb Ischemia: If blood flow to major arteries is compromised.
Diagnostic Tools
- CT Scan: Most commonly used and highly effective.
- MRI: Offers detailed images, but less used due to time constraints.
- Transesophageal Echocardiogram (TEE): Invasive but provides detailed images of the aorta.
Treatment
- Emergency Medical Care: Immediate stabilization is critical.
- Surgical Repair for Type A Dissections: Involves replacing the affected part of the aorta.
- Medical Management for Type B: Blood pressure control to prevent worsening of the dissection.
- Ongoing Monitoring: Regular imaging to check the status of the dissection.
Complications
- Rupture of the Aorta: Leading to life-threatening internal bleeding.
- Organ Damage: Due to impaired blood flow.
- Stroke or Paralysis: If blood flow to the brain or spinal cord is affected.
Prevention and Monitoring
- Control of Risk Factors: Especially hypertension.
- Regular Check-Ups: For individuals with connective tissue disorders or family history.
- Lifestyle Changes: Healthy diet, regular exercise, and avoiding tobacco and illicit drugs.
Reference articles
- Aortic Aneurysm and Dissection: A Critical Guide for Understanding and Management
- Peripheral Arterial Disease Demystified: A Complete Guide to PAD
- Aortic Valve Disease Explored: Understanding, Diagnosis, and Management
- Coarctation of the Aorta Uncovered: A Critical Guide to Diagnosis and Management
- Decoding Congenital Anomalies: Understanding Birth Defects and Their Impact
- Arterial Embolism & Thrombosis Decoded: A Journey Through Vascular Blockages
- Vasculitis Unveiled: A Comprehensive Guide to Vascular Inflammation
- Unraveling Aortic Dissection: A Critical Insight into a Silent Killer
- Subclavian Stenosis & Occlusion: Navigating the Silent Vascular Threat
- Deciphering Radioradial & Radiofemoral Delay: A Cardiovascular Insight