Aortic dissecting aneurysm can be life threatening. When an aneurysm appears in the weakened aortic wall, aortic dissection occurs. It is a dangerous situation and it is very difficult to diagnose it because the symptoms are similar to those associated with a heart attack. How to recognize aortic dissecting aneurysm? How is it treated?

Aortic dissecting aneurysmis usually a consequence of hypertension. When the blood pressure in the arteries is too high, the vessels stretch in weaker places (called an aneurysm) and the inner - one of the three - layers that make up the arteries ruptures. The blood flows through the rupture between the inner and middle layers and causes them both to fall apart. Then the same thing can happen with the next layers and it happens that the artery ruptures. Then there is a hemorrhage. This is the most dangerous moment for life.

Aortic dissection affects most people suffering from hypertension, but that does not mean that it awaits everyone who suffers from it. The likelihood of aortic dissection increases:

  • in men aged 50-60
  • women in the third trimester of pregnancy
  • smokers
  • drug users (especially cocaine)
  • suffering from certain congenital diseases of the heart and circulatory system (e.g. Marfan, Ehlers-Danlos syndrome)
  • in people who have had a blunt chest injury.

Aortic dissection hurts

The aorta is the main blood vessel that carries blood from the heart to other parts of the body and extends from the chest to the lower abdomen. As much as 60-70 percent. Aortic dissecting aneurysms are located in the ascending aorta, i.e. in the thoracic segment closest to the heart. Therefore, the most characteristic symptom of progressive aortic dissection is severe and violent pain in the chest or back, sometimes it can be described as migratory: it follows the delamination process, radiating to the shoulders, neck, jaw, abdomen and hip. Usually it is accompanied by rapid and profuse sweating, dizziness, feeling anxious, vomiting. There is also circulatory failure (cardiogenic shock). Pressure measurements on both hands may show different values. If the aorta ruptures, there is painsudden and very strong. When the dissection touches the arteries going down to the legs, it causes violent pain in the limbs. Unfortunately, dissection - due to misdiagnosis - often goes undiagnosed and untreated. Meanwhile, saving a life requires a quick and precise response as soon as symptoms appear. The diagnosis is made on the basis of examinations - ultrasound, computed tomography, magnetic resonance imaging and angiography, i.e. X-ray of the vessels with the use of contrast fluid.

Aortic dissection: treatment

Treatment depends on the severity and site of the aortic dissection. If the dissection occurs just above the coronary arteries, its repair usually requires cardiac surgery. It consists in opening the chest, tightening the aorta and replacing its damaged section. Endovascular repair is a modern alternative to this method. A special vascular prosthesis (stent graft) is inserted into the damaged area through a small incision in the groin. If the dissection affects the descending aorta, below the exit of the left subclavian artery, and if the disease can be diagnosed early, pharmacological conservative treatment can be counted on. It is based on aggressive lowering of blood pressure, which is supposed to inhibit the dissection process and promote wound healing.

Important

Aortic dissecting aneurysm is a direct life threat, and the mortality rate among those who fail is enormous (75 percent of patients die within the first two weeks).

Aortic aneurysm

Aortic aneurysm is a dilation of the aorta above 50 percent of normal. Cardiologists usually treat the ascending aortic aneurysm. What causes an aortic aneurysm? What are the symptoms of an aortic aneurysm? Listen to our expert prof. Piotr Hoffman, president of the Polish Society of Cardiology.

Category:

Cardiology