Dissection of the aorta
What is it?
Dissection of the aorta is a disease of the aortic wall in which the inner layer ruptures and separates from the media and can be fatal in many cases. Most aortic dissections occur because high blood pressure causes deterioration of the arterial wall. Aortic dissections are 3 times more common in men, more common among black individuals (especially African Americans), and less common among Asians. Approximately three quarters of cases of aortic dissection occur in individuals between the ages of 40-70 years old. The most common cause is chronic hypertension. Less common causes of dissection of the aorta include hereditary connective tissue diseases, congenital abnormalities, and trauma such as a car accident.
Which are the symptoms?
Aortic dissection causes pain, usually sudden, sharp, and described as tearing or laceration. Pain is usually felt in the chest, but often also in the back, between the shoulders. Pain often occurs along the dissection pathway as it progresses along the aorta.
- chest or retrosternal, abdominal and/or lumbar pain
- difficulty in breathing
- renal failure
- heart failure
How is it diagnosed?
Patients with the described symptoms are at high risk for suspicion of aortic dissection and should undergo imaging tests.
How is it treated?
All patients with acute aortic dissection should be initially treated in the intensive care unit with adequate monitoring of vital parameters such as heart rate, blood pressure, and respiratory rate. Surgical treatment depends on the location of the dissection and complication factors. Operation can be performed by open surgery or endovascular method.
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