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Aortic Dissection

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  3. Aortic Dissection

Overview of Aortic Dissection

Aortic dissection is one of the many heart conditions that affect older people. It is a medical emergency that can quickly become fatal.

Aorta is the largest and major artery in the body carrying the blood out of the heart and supplying the oxygen-rich blood to the other parts of the body.
The aorta is an elastic artery, meaning it can expand.
Aortic Dissection ( سینه کے اورطہ میں چیر کا خانہ بنانا)is the tear in the wall of the aorta. It is a serious condition in which the tear on the wall extends along the wall of the aorta. Hence, the dissection.
This can lead to aortic rupture and loss of blood flow to other organs in the body.
Aorta has three layers. The tear resides in the inner layer. Aortic dissection leads to the separation of the layers of the aorta.

Signs and Symptoms of Aortic Dissection

The symptoms of aortic dissection are similar to a heart attack. Symptoms include:

 

  • Sudden and severe pain in the back
  • Sweating
  • Shortness of breath
  • Loss of consciousness
  • Abdominal pain
  • Leg pain
  • Loss of vision
  • Paralysis
  • Tingling, numbing, or pain in the toes or fingers
  • Trouble walking
  • A weaker pulse in one arm than the other
  • Dizziness
  • Nausea

 

Types of Aortic Dissection

There are two types of aortic dissection depending on the location of the dissection.

  • Type A

This is the most dangerous and most common type. The ascending aorta or the upper aorta has a tear that can extend into the abdomen or in the area where the aorta leaves the heart.

  • Type B

This type is less life-threatening. Descending aorta suffers from the dissection which is called Type B Dissection.

Causes of Aortic Dissection

Causes and risk factors of aortic dissection are intermingled. The following factors increase the risk of aortic dissection:

  • Age
  • Men in their 60’s and 70’s
  • Hypertension
  • Tobacco smoking
  • Heart surgery
  • Hardening of the arteries or atherosclerosis
  • Bicuspid aortic valve
  • Narrowing of the aorta
  • Chest injury
  • Drug addiction especially cocaine
  • Pregnancy
  • Pre-existing aortic aneurysm
  • Genetic diseases such as Turner’s syndrome, and Marfan’s syndrome
  • Connective tissue disorders

 

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Risk Factors of Aortic Dissection

Some of the risk factors of aortic dissection are as follows:

Uncontrolled high blood pressure

  • Atherosclerosis

The deposition of fatty acids in the arteries

  • Aortic Aneurysm

An artery that is weak and is bulging

  • Bicuspid Aortic Valve

An aortic valve that has two valves instead of the normal three

  • Aortic Coarctation

Narrowing a specific portion of the aorta

Complications of Aortic Dissection

Several given below complications can arise due to aortic dissection:

 

  • Severe internal bleeding that can result in death
  • Organ damage such as liver or kidney damage
  • Permanent damage to the aortic valve or disruption of the inner lining
  • Stroke

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Prevention

With the help of the given below preventive strategies the onset of this disease can be reduced:

  • Quit Smoking

Tobacco smoke contains a handful of cancerous substances that are damaging to your body. Try to get rid of this habit

  • Maintain a Healthy Weight

Consume fruits and eat a balanced diet. Limit cholesterol intake as much as you can. Try to eat whole grains and fibrous foods.

  • Control Your Blood Pressure

Try to maintain your blood pressure. Do not eat foods that are rich in salt.

  • Take Precautionary Measures While Traveling

Make sure to wear a seatbelt when you are traveling. This lowers your chances of a chest injury.

 

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Diagnosis

First, a physical examination will be done. The doctor will ask for all your medical records, your family history, as well as any symptoms that you might be possibly facing.

Sensitive imaging techniques are used to give a proper diagnosis; these include:

A Computerized Tomography scan or CT scan of the chest with IV contrast is done to make the heart, aorta, and other blood vessels visible. A tear is visible in the scan.

  • TEE

A Transesophageal Echocardiogram or TEE uses an ultrasound probe to produce an image of the heart.

  • MRA

An MRA or Magnetic Resonance Angiogram is used to look at the blood vessels. This is very helpful in diagnosing a dissection.

All of the above-mentioned diagnostic tests are available all over Pakistan.

Treatment of Aortic Dissection | When to Consult a Doctor

An aortic dissection immediately requires treatment and is termed a medical emergency. Postoperative therapy is recommended.

  • Type A Aortic Dissection 

The following treatment is done for Type A Aortic Dissection:

  1. Surgery

During surgery, the dissected aorta (tear in the wall) is removed to the maximum. A graft is a synthetic tube used to reconstruct the aorta. The valve can also be replaced in case of a leak.

  1. Post Surgery Medications

Beta-blockers and nitroprusside are given for many heart conditions. They lower blood pressure and heart rate. They are also given to lower blood pressure before surgery.

  • Type B Aortic Dissection

  1. Surgery

Stents are used to repair Type B Aortic Dissections. The procedure is almost similar to type A surgery.

  1. Post Surgery Medications

Medications similar to that of type A are used. They are prescribed even without the surgery.

Usually, hypertension medication is prescribed for life, and follow-up after every few months is recommended.

 

Aortic Dissection is life-threatening and needs to be tackled as a priority. Pakistan has one of the best cardiac hospitals. Much has been achieved and research has been done in the field of cardiology. Consult a qualified cardiologist near you for your condition. 

 

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