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Aortic Dissection

The aorta is the largest blood vessel in the body and is responsible for carrying oxygenated blood from the heart to the rest of the vascular system. Made up of three layers of thick muscle, the aorta withstands high pressures created every time the heart pumps blood. A tear in one of those layers is called an aortic dissection.

When dissection occurs, blood flows between the layers of the aorta, forcing the layers to separate from one another. There are several types of aortic dissections which are characterized both by their location and severity.

Either way, when a tear occurs, it can result in significant decrease in blood flow to organs and tissues throughout the body including the kidneys, stomach, brain, arms and legs. In addition, a tear in the aorta may alter the blood flow to the heart causing a heart attack and or internal bleeding around the heart. If a dissection tears through all three layers of the aorta, rapid and massive blood loss can occur.

Regardless of the type of tear, an aortic dissection is a very serious disorder that requires immediate medical attention.

What Causes Aortic Dissection?

Aortic dissection tends to occur most commonly in men between the ages of 50 and 70 and the majority of cases are associated with high blood pressure, also known as hypertension. This is because the aorta undergoes significant pressure changes with every heart beat and high blood pressure is thought to weaken the innermost layer of the vessel.

In addition to hypertension, there are a number of illnesses associated with aortic dissection, including:

• Bicuspid aortic valve (a congenital abnormality of the aortic valve)

• Marfan's syndrome

• Turner syndrome

• Syphilis

• Ehlers-Danlos syndrome

Rarely, aortic dissection can be caused by pregnancy, especially in the third trimester and early post-partum period. This is because of increased blood flow in the mother during pregnancy.

Aortic dissection can also occur when a person undergoes a traumatic event, such as a car accident.

What are the signs and symptoms of aortic dissection?

The signs and symptoms of aortic dissection are similar to those of other heart problems. If you experience these, you should seek immediate medical attention.

• Sudden, severe chest or upper back pain

• Loss of consciousness

• Shortness of breath

• Weakness

How is an aortic dissection detected?

In order to determine if you are experiencing an aortic dissection, your physician will order any or all of the following tests:

• Computerized tomorgraphy (CT) scan

• Magnetic resonance angiogram (MRA)

• Transesophageal echocardiography (TEE)

How is an aortic dissection treated?

Depending on the type of aortic dissection you have, you will either be placed on medication, or you will require surgery.

If you are placed on medication, your doctor will monitor your dissection at regular intervals to ensure the tears is not getting worse.

Many patients undergo surgery to repair an aortic dissection. During surgery, the area of aorta that is damaged is replaced with an artificial graft. Sometimes, the aortic heart valve is damaged from the dissection. If that is the case, it too may be either replaced or repaired.

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