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What is an Aortic Dissection by Eric Hegger

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An aortic dissection occurs when you develop a tear in the inner layer of the aorta. Blood rushes out of the opening caused by the tear and into the middle layer of the aorta. This causes a separation between the middle and inner layers of the aorta. The aorta then swells up and can rupture if it is not caught in time, which often results in death. Aortic dissections are not very common but can develop in anyone. Although, when they do occur, dissected aortas are seen most often in men between the ages of 60 and 70.

By the time of diagnosis in most people, it’s usually too late. The symptoms are very similar to other more common diseases and are easily misdiagnosed at the start. The symptoms of an aortic tear include but are not limited to severe chest and upper back pain that radiates down the back or up the neck, shortness of breath, or fainting. This disease is often misconstrued as a heart attack or symptoms of overwhelming stress. If the doctors detect and diagnose this condition early enough and treat it properly with surgery or medication the patient’s chance of survival greatly improves.

An aortic dissection occurs due to a weakened aortic wall which eventually breaks down and tears. Chronic high blood pressure can be a contributing factor to weakening the aortic tissue, making a tear more likely. Some individuals are born with a condition in which they have an enlarged or weakened aorta. Those individuals are more susceptible to an aortic dissection. In the rarest cases, aortic dissections may occur as a result of traumatic injuries to the chest area. To reduce your risks of having an aortic dissection control your blood pressure, don’t smoke or stop now if you do, maintain an ideal weight, wear a seatbelt, and be aware of your family history.

There are two types of aortic dissections. Type A, the most dangerous and also most common of the two involves a tear in the aorta just off the heart on the upper and/or lower region of the aorta. Type B occurs when there is a tear only on the lower part of the aorta away from the heart. Type A requires surgery as a treatment and in most cases it is fatal. Type B, if caught and treated properly, can heal often without surgery.

In the surgery required to treat a type A aortic dissection, doctors will remove as much of the damaged aorta as possible and replace it with a synthetic graft. Along with replacing the aorta, many times the doctors will also have to replace the aortic valve with a graft to prevent leakage. When a patient has a type B aortic dissection they can be treated a few different ways. One of the methods includes a surgery similar to that required in a type A tear. The tear may also be fixed using stents to strengthen the wall of the aorta. However, most cases of type B dissections can be treated with medication alone. These medications include beta blockers and sodium nitroprusside which relieve force on the wall of the aorta allowing the aorta to heal on its own.


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