This book describes Aortic Dissection, Diagnosis and Treatment and Related Diseases

Aortic dissection is a serious disorder in which there is a tear in the wall of the major artery carrying blood out of the heart (aorta).

When the tear expands along the wall of the aorta, blood can stream in between the layers of the blood vessel wall (dissection).

Blood dashes through the tear, inducing the inner and middle layers of the aorta to split (dissect).

This can cause aortic rupture or reduced blood flow (ischemia) to organs.

If the blood goes through the outside aortic wall, aortic dissection is often fatal.

When an aortic dissection is diagnosed early and treated quickly, the chance of survival significantly improves.

Aortic dissection most often happens due to a tear or damage to the inner wall of the aorta.

This very often happens in the chest (thoracic) part of the artery, but it may also happen in the abdominal aorta.

When a tear happens, it produces 2 channels:

One in which blood persists to travel

Another where blood remains still

If the channel with non-traveling blood becomes larger, it can push on other branches of the aorta.

This can narrow the other branches and decrease blood flow through them.

An aortic dissection may also produce abnormal widening or ballooning of the aorta (aneurysm).

Aortic dissections are classified into two groups, depending on which part of the aorta is involved:

Type A

This frequent and dangerous type produces a tear in the part of the aorta where it exits the heart.

The tear may also happen in the upper aorta (ascending aorta), which may extend into the abdomen.

Type B

This type causes a tear in the lower aorta only (descending aorta), which may also extend into the abdomen.

Risk factors

Uncontrolled high blood pressure (hypertension)

Hardening of the arteries (atherosclerosis)

Weakened and bulging artery (aortic aneurysm)

An aortic valve defect (bicuspid aortic valve)

Narrowing of the aorta at birth (aortic coarctation)

Blunt trauma to the chest, such as hitting the steering wheel of a car during an accident

Heart surgery or procedures

Swelling of the blood vessels due to disorders such as arteritis and syphilis

Inflammation of the arteries (giant cell arteritis) may increase the risk of aortic dissection.

Certain genetic diseases raise the risk of having an aortic dissection, such as:

Turner syndrome: High blood pressure, heart problems

Marfan syndrome: This is a disorder in which connective tissue supporting various structures in the body, is weak.

Other connective tissue disorders:

Ehlers-Danlos syndrome, connective tissue disorders that produce loose joints and fragile blood vessels and Loeys-Dietz syndrome, which produces twisted arteries, particularly in the neck.

Other possible risk factors

Sex: Men are more likely than women.

Age: Aortic dissection is more likely in ages 60 and older.

Cocaine use: This drug raises blood pressure.

Pregnancy: Often aortic dissections occur during pregnancy.

High-intensity weightlifting: This raises blood pressure

In most cases, the symptoms start suddenly, and involve severe chest pain

Echocardiography is the imaging method for detecting aortic dissection

An aortic dissection is a medical emergency requiring immediate treatment.

Dissections in the part of the aorta leaving the heart (ascending) are treated with surgery.

Dissections in other parts of the aorta (descending) may be treated with surgery or medicines.

TABLE OF CONTENT

Introduction

Chapter 1 Aortic Dissection

Chapter 2 Causes

Chapter 3 Symptoms

Chapter 4 Diagnosis

Chapter 5 Treatment

Chapter 6 Prognosis

Chapter 7 Thoracic Aortic Aneurysm

Chapter 8 Abdominal Aortic Aneurysm

Epilogue