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AORTIC

DISSECTION
Aortic dissection is a serious condition in which there is a tear in the wall of the major
artery carrying blood out of the heart (aorta).
Causes:
1st- when it leaves the heart
2nd- aorta first moves up through the chest towards the
head (the ascending aorta).
3rd- bends or arches, and finally moves down through
the chest and abdomen (the descending aorta).
When a tear occurs, it creates two
channels:
One in which blood continues to travel
Another where blood stays still

If the channel with non-traveling blood gets bigger, it can push on other branches of the
aorta.
This can narrow the other branches and reduce blood flow through them.

An aortic dissection may also cause abnormal widening (aneurysm)


Other risk factors and conditions linked to aortic
dissection include:

Bicuspid aortic valve

Coarction (narrowing of the aorta)

Connective tissue disorders such asMarfan and Ehlers-Danlos syndrome

and rare genetic disorders


MARFAN SYNDROME
Ehlers-danlos syndrome
Symptoms

In most cases, the symptoms begin suddenly, and include severechest pain. The
pain may

feel like a heart attack and it:

Described as sharp, stabbing, tearing, or ripping

Is felt below the chest bone, then moves under the shoulder blades or to the
back

Can move to the shoulder, neck, arm, jaw, abdomen, or hips

Changes position, often moving to the arms and legs as the aortic dissection
Symptoms are caused by a decrease of blood flowing
to the rest of the body, and can include:

Anxiety and a feeling of doom Other symptoms may include:


Fainting or dizziness
Pain in the abdomen
Heavy sweating (clammy skin)
Nausea and vomiting Stroke symptoms
Pale skin (pallor)
Swallowing difficulties from pressure
Shortness of breath and trouble breathing when
on the esophagus
lying flat (orthopnea)
Exams and Tests
A health care provider will auscultation the heart, lungs, and
abdomen with a stethoscope. The exam may find:
A "blowing" murmur over the aorta, heart murmur, or other abnormal sound
A difference in blood pressure between the right and left arms, or between the
arms and legs
Low blood pressure
Signs resembling a heart attack
Signs ofshock but with normal blood pressure
Aortic dissection or aortic aneurysm may be seen on:

Aortic angiograph
Chest x-ray
Chest MRI
CT scan of chestwith dye
Doppler ultrasonography(occasionally performed)
Echocardiogram
Transesophageal echocardiogram (TEE)
Blood work to rule out a heart attacks needed.
Treatment
Aortic dissection is a life-threatening condition and needs to be treated
right away.
Dissections that occur in the part of the aorta that is leaving the heart
(ascending) are treated with surgery.
Dissections that occur in other parts of the aorta (descending) may be
managed with surgery or medicines.
Two techniques may be used for surgery:

Standard, open surgery


requires a surgical incision thatis made in the chest or abdomen.

Endovascular aortic repair


done without any major surgical incisions.

Drugs that lower blood pressure may be prescribed:


drugs may be given through a vein (intravenously). Beta-blockers are the first drugs of choice.
Strong pain relievers are very often needed.

If the aortic valve is damaged, valve replacement is needed.


If the heart arteries are involved, a coronary bypass is also performed.
POSSIBLE
COMPLICATIONS
Possible Complications
Aortic dissection may decrease or stop the blood flow to many different
parts of the body. This may result in short-term or long-term problems, or
damage to the:
Brain
Heart
Intestines or bowels
Kidneys
Legs
Prevention

Things you can do to reduce your risk include:


Treating and controlling hardening of the arteries (atherosclerosis)
Keeping high blood pressure under control, especially if you are at risk for dissection
Taking safety precautions to prevent injuries that can cause dissections
If you have been diagnosed with Marfan or Ehlers-Danlos syndrome,
making sure you regularly follow-up with your doctor
Before and after surgery to correct Type A dissection
THANK YOU!

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