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The aorta is the main artery of the body. It originates from the heart and extends down into the abdomen. The aorta is responsible for distributing blood to the whole body. Aortic dissection is a serious medical condition in which the inner layer of the aorta tears, allowing blood to flow in between the layers, forcing them apart. In many cases, aortic dissection can cause rupture of the aorta, and death.

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Risk Factors

Aortic dissection is not a common medical condition. It typically occurs in men above the age of 60 with other underlying medical conditions. Chronic high blood pressure increases the risk of aortic dissection because it means constant pressure on the aorta, making it more susceptible to tears. Atherosclerosis also increases the risk of aortic dissection. Other risk factors involve conditions of weakened or enlarged aorta such as Marfan syndrome, bicuspid aortic valve, or other rare conditions. There is evidence that repeated cocaine use may also increase the risk of aortic dissection because it temporarily raises blood pressure. High intensity weight-lifting is another activity which may increase the risk because it raises blood pressure. Rarely, pregnant women will experience aortic dissection in an otherwise healthy pregnancy.

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Symptoms

Symptoms of aortic dissection can mimic those of a heart attack. According to the Mayo Clinic, the most common signs and symptoms experienced by people with aortic dissection include:

  • Sudden and severe chest pain described as a tearing or ripping sensation
  • Sudden or severe abdominal pain
  • Anterior chest pain
  • Neck or jaw pain
  • Mild chest pain in some cases
  • Loss of consciousness
  • Shortness of breath
  • Changes in mental status: difficulty speaking, loss of vision, weakness or paralysis of one side of the body (similar to that of a stroke)
  • Weak pulse in one arm
  • Leg pain
  • Difficulty walking
  • Leg paralysis
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Complications

When an aortic dissection is detected and treated right away, the chance of survival improves. Left untreated, it can lead to other serious medical conditions, and death. According to the Mayo Clinic, aortic dissection may lead to:

  • Organ damage
  • Stroke
  • Aortic valve damage or rupture of the lining around the heart
  • Death due to internal bleeding
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Diagnosis

Because symptoms of aortic dissection mimic those of other, more frequent medical conditions, it may be difficult to diagnose. Telltale signs of an aortic dissection which may help the doctor set it apart from a heart attack include blood pressure differences between the two arms, widening of the aorta on an x-ray, and the ripping sensation that the patient feels. Your doctor may order the following tests:

  • X-ray. Up to 20% of aortic dissections are detectable in a chest x-ray. In most cases, more advanced imaging tests will need to be done.
  • Computed tomography (CT). Your doctor will get a three-dimensional view of the aorta using this test.
  • Transesophageal echocardiogram (TEE). This is an ultrasound test in which the probe is inserted into the esophagus. Sound waves are used to produce an image of the heart.
  • Magnetic resonance angiogram (MRA). In this test, a magnetic field, radio waves, and a computer are used to look at the blood vessels.
  • Aortogram. For this test, a catheter is placed in the aorta which then injects contract material to make it visible in an x-ray. At the same time, x-rays are taken.
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Treatment

Depending on the location and severity of aortic dissection, treatment may differ. The two main options, though, are medication and surgery. In surgery, the torn segment of the aorta is removed. The aorta may need to be reconstructed using a synthetic tube— also known as a graft. In some cases, the aortic valve may need to be replaced as well. If the tear occurs only in the descending aorta or the arch (known as Type B aortic dissection), a stent may be used to repair the aorta. Medications to reduce heart rate and blood pressure may be used when aortic dissection is diagnosed. The objective is to prevent aortic dissection from getting worse. Medications may include beta blockers, vasodilators, and calcium channel blockers.

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Prevention

If you are at risk for aortic dissection, talk to your doctor about things you can do to lower your risk. These are the steps you can take at home to lower your risk:

  • Quitting smoking
  • Exercising regularly. Talk to your doctor about which exercises are safe for you
  • Controlling blood pressure. Track your blood pressure and take the necessary steps to keep it at a safe level. Lower your sodium intake and if necessary, take blood-pressure-reducing medication.
  • Maintaining a healthy weight. Being overweight is a risk factor for high blood pressure, atherosclerosis, and other things which may lead to aortic dissection.

If you have a family history of aortic dissection, let your doctor know. Maintaining a healthy lifestyle is one of the best ways to reduce your risk of heart disease, stroke, and conditions like aortic dissection.

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Disclaimer

This site offers information designed for educational purposes only. You should not rely on any information on this site as a substitute for professional medical advice, diagnosis, treatment, or as a substitute for, professional counseling care, advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional.