Aortic Dissection

Aortic dissection occurs when the inner lining of the aorta (intima) tears, allowing blood to force its way between the layers of the vessel wall. This creates a false channel that can compromise blood flow to vital organs. Several factors contribute to this condition, including:

Atherosclerosis and Inflammation:

The accumulation of fatty deposits (plaques) and inflammatory cells weakens the aortic wall over time:

• Chronic inflammation, often associated with hypertension, autoimmune diseases, or infections, accelerates connective tissue degradation in the aorta

High Blood Pressure (Hypertension): Persistent high pressure increases mechanical stress on the aortic wall, making it more susceptible to tearing.

Connective Tissue Disorders and Genetic Conditions:

• Marfan syndrome, Ehlers-Danlos syndrome, and bicuspid aortic valve disease affect collagen and elastin, critical for aortic integrity.
• People with these conditions have a higher risk of spontaneous aortic dissection.

Aortic Aneurysm:

• Aneurysms (bulges in the aortic wall) can weaken the artery and increase the risk of rupture or dissection.
• Abdominal aortic aneurysms (AAA) occur in the lower aorta, while thoracic aortic aneurysms (TAA) develop in the chest.

Other Risk Factors:

• Smoking accelerates aortic wall degeneration.
• Trauma, such as high-impact injuries, can trigger an acute aortic dissection.
• Pregnancy, due to hormonal changes affecting vascular elasticity.

Aortic dissections are classified based on their location:

Type A:

• Occurs in the ascending aorta, near the heart.
• This type is highly fatal without emergency surgery.

Type B:

• Occurs in the descending aorta, affecting the lower chest and abdomen.
• Treatment may involve blood pressure control or endovascular stent placement.

Aortic dissection can mimic other cardiac emergencies, such as a heart attack. The key symptoms include:

• Severe, tearing or ripping chest and back pain (radiating to the neck, arms, or abdomen)
• Cold, clammy skin and excessive sweating
• Fainting, dizziness, or confusion
• Shortness of breath and difficulty breathing

Aortic dissection is a medical emergency. If you suspect symptoms, call 999 immediately.

Emergency Surgery (for Type A):

• Open-heart surgery to replace the damaged aortic section with a synthetic graft.

Endovascular Stenting (for Type B):

• A minimally invasive procedure where a stent graft is placed to support the weakened aorta.

Medications:

• Beta-blockers and antihypertensive drugs help lower blood pressure and reduce stress on the aortic wall.

Lifestyle Modifications:

• Smoking cessation, blood pressure control, and cholesterol management help prevent recurrence.