Recognizing Aortic Dissection
Much has been written concerning the diseases that can strike the human heart. Nevertheless, the said diseases can be prevented if diagnosed at an early stage. Aortic dissection is considered as one of the most catastrophic heart diseases that, if left untreated, could claim the lives of about 33% of people suffering from it within the first 24 hours, while 50% of the patients die within the span of 48 hours (Wiesenfarth). Considered as the major heart artery, aorta is responsible for carrying the blood from the heart to other body parts. The occurrence of aortic dissection happens when the inner layers of the aorta artery wall dissect or split due to the high pressure of blood flow on the wall of the artery.
The dissections of the aorta can occur in the ascending aorta or the aorta’s first segment, wherein the aorta originates from the pumping chamber of the heart or the left ventricle. If the aortic wall in the said area dissects, pulses of blood would rush through the artery wall as well as under the inner layers, causing the aorta to split further. Usually, the tear extends away from the heart (distally) towards the descending aorta and its major branches, while in some cases, the tear may also run back toward the heart (proximally). Aortic dissection can also begin at the distal or descending portion of the aorta (American Heart Association [AHA]).
The most common symptom of acute aortic dissection is characterized with an onset of a very severe and tearing chest pain that is often associated with cold sweat. Typically, the pain is felt in the front or the back of the chest, and by the time the dissection gets worse, the pain heightens as well. Other signs and symptoms of the disease are dependent on the involvement of other arterial branches of the heart as well as the compression experienced by nearby organs. It was also found that men are more susceptible to aortic dissection than women. Proximal dissection’s peak age takes place between 50 and 55, while distal dissection is more likely to occur between the ages of 60 and 70 (AHA). Likewise, the disease is also more likely to strike individuals who are suffering from diseases that affect the aorta such as hypertension, disorders of the connective tissues, and congenital aortic stenosis, which predispose an individual to aortic dissection. The disease can also be acquired by a person who has a family history of thoracic dissections. The occurrence of aortic dissection is also attributed to pregnancy, syphilis, and the use of crack cocaine (Wiesenfarth).
Since acute aortic dissection is considered as an emergency, immediate medical treatment is needed. Initial therapeutic goals can be accomplished by admitting the patient in an intensive care unit to eliminate pain and reduce blood pressure and heart rate of the patient to a level that is adequate to the functions of the vital organs. In some instances, urgent surgical interventions are done, while recent alternative procedures like stent placement in the aorta are also applied to patients that are considered as high-risk (AHA).
Despite the advancement in the techniques of diagnosing and repairing aortic dissection, it is still crucial for the person suffering from the disease to practice prehospital care. Although the diagnosis of aorta dissection may be difficult because of the similarity of the signs and symptoms of the disease to other cardiovascular diseases, studying and observing the salient features of aortic dissection can be done in order to prevent exacerbations that could result in fatality. Likewise, constant and early consultation is encouraged in order to develop further imaging studies that could be helpful for future interventions.
American Heart Association. “Aortic Dissection.” 2009. 28 January 2009
Weisenfarth, John. “Dissection, Aortic.” eMedicine. 08 November 2007. 28 January 2009