About the disease

Aortic dissection is tearing of the inner layer of aorta when blood enters the walls of aorta instead of passing blood from the heart. Overall, aorta is the biggest artery of human body, responsible for carrying out the blood from heart ventricles. Such little hemorrhage can also develop if blood accumulated on the inner wall of aorta from tiny vessels, which supply the aorta from its outside wall. In severe cases, blood dissection can cause complete draining of blood from aorta resulting in artery rupture. Thus, this condition is a medical emergency and needs to be treated immediately after diagnosis. It often manifests itself with symptoms similar to heart attack as a person stops receiving sufficient amount of blood from the heart, resulting in overall decrease of health indicators. Usually pain in the heart appears very suddenly and starts to radiate to organs, where there is insufficient amount of blood. Pulse also becomes extremely weak and difficult to find. A person may have trouble speaking and formulating the thoughts. This is the direct indicator of a possible rupture and, then a person needs to be hospitalized immediately in order to prevent fatal outcome. In other cases, aortic dissection can develop chronically and manifest itself in numb pain in the chest for a long period of time before an actual attack. In this case a person needs to undergo check-up at cardiologist. Aortic dissection is in most cases caused by long-term high blood pressure and hypertension, as these conditions put the highest pressure on artery walls and vessels which surround these walls. Previous injuries and surgeries in the chest area can also contribute to development of aortic dissection in future. In some people, genetic predisposition and acquired heart abnormalities cause aortic dissection. Aortic dissection is more common in males over 50 years old.      

Symptoms

• Chest pain
• Severe pain in the heart
• Dizziness
• Fatigue
• Nausea
• Muscle weakness on one side of the body
• Confusion

Diagnosis

• During a general examination a doctor listens to patient`s heart through the stethoscope in order to detect any noises, which could be causing chest pain. A doctor also measures blood pressure to see if it is too high and deviates from normal.  
• ECG is used to monitor the electrical activity of the heart. This diagnostic measure is also good in differentiating aortic dissection from the heart attack.
• An echocardiogram creates image of the heart and its arteries and can detect if there is either accumulation of blood in aorta or if blood is leaking out from the artery.

Treatment

Treatment for aortic dissection depends on the type of this disease. If it is caused by high blood pressure and does not present danger at this given time, a person may be prescribed special drugs to lower the blood pressure. After that, he needs to be monitored regularly by the cardiologists in order to prevent any dissections. In most cases, nonetheless, a person needs to undergo surgery in order to prevent rupture.

• Resection with anastomosis is a surgery, used to connect aorta in the place where it has been torn down. During this surgery a doctor normalizes the inner wall of aorta in order to let blood freely pass it.
• Grafting of the aorta may be used to replace the torn part of aorta with the new one. 

Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed