The aorta is the primary artery that carries oxygen-rich blood from the heart to the rest of the body. Its wall comprises three tissue layers: adventitia, or outer layer; media, or middle layer; and intima, or inner layer. Aortic dissection occurs suddenly when a rupture happens within the inner lining of a weakened section of the aorta. Blood surges via the tear, resulting in the middle and inner layers dissection.
When blood redirects amidst the tissue layers, it ceases or impedes normal blood circulation to different body regions or, in extreme cases, causes a complete aortic rupture. It is a life-threatening condition and may result in sudden death if not diagnosed and treated quickly.
Causes
Aortic dissection occurs in areas where the aortic wall weakens. Prolonged elevation in blood pressure can gradually impair the strength of your aortic tissue. In some people, the weakness stems from a condition (such as Marfan syndrome) you are born with that affects the aorta’s size and strength. In rare cases, a traumatic chest injury (for instance, from a car accident) may also be one of the causes of aortic dissection.
Risk factors
Aortic dissection typically affects men between the ages of 60 and 80. Men are two times more susceptible to developing an aortic dissection than women. A few things that make you more susceptible to aortic dissection are as follows:
- Arterial hardening, also known as atherosclerosis
- Uncontrolled hypertension, indicating high blood pressure
- Existence of a weakened or bulging artery beforehand
- Aortic valve with two leaflets, termed bicuspid valve
- Constriction of the aorta at birth, referred to as aortic coarctation
- High-intensity weight lighting
- Pregnancy
Some genetic conditions also amplify your chances of developing aortic dissection. Some such causes are as follows:
- Turner’s syndrome: Turner’s syndrome, an exclusive condition for women caused by the absence of a single X chromosome, may result in hypertension and cardiac complications, among other symptoms.
- Connective tissue disorders: Connective tissue disorders, including Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome, can induce vulnerability in blood vessels.
- Certain inflammatory conditions: Certain inflammatory conditions like giant cell arteritis and syphilis have the potential to impact blood vessels as well.
Symptoms
Aortic dissection signs often mimic symptoms of other heart problems, like heart attacks. A few common aortic dissection symptoms are as follows:
- Abrupt and intense chest or upper back pain is commonly described as a sensation of tearing or ripping, which radiates toward the neck or along the spine
- Sudden and severe abdominal pain
- Loss of consciousness
- Breathlessness or difficulty breathing
- Stroke-like symptoms, such as sudden vision impairment, speech difficulties, and weakness or paralysis affecting one side of the body
- Uneven pulse strength between one arm or thigh and the other
- Pain in the leg
- Impaired mobility or walking challenges
Treatment
Aortic dissection demands immediate medical treatment to avoid death or severe complications. Your doctor may recommend prescription treatment, surgery, or both to monitor symptoms.
- Prescription treatment: Doctors may suggest certain prescriptions to people with type B aortic dissection to lower blood pressure and heart rate and prevent the tear from worsening. People with type A may also need these treatments to stabilize the condition, but they mostly need surgery to rectify the tear.
- Surgery: Those with type A aortic dissection will require surgery to rectify the aorta’s damaged section and replace it with a tube to prevent the blood from entering the aortic wall. Your doctor will also replace the leaking aortic valve. Further, those with type B may also need surgery, but their procedure will involve stents, small mesh tubes for aortic repair.
