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What is Aortic Dissection?
Aortic Dissection is a tear in the inner lining of the aorta (the large blood vessel that leads from the heart to the rest of the body). This mostly occurs in patients who are older, have high blood pressure, enlargement of the aorta from aortic valve disease (especially a bicuspid aortic valve) or Marfan syndrome. Aortic dissection can occur in the ascending aorta (near the heart) or in the descending aorta (where the aorta runs down the back of the chest to the legs). This is a life threatening problem and requires immediate attention.
What are the symptoms?
Patients have the sudden onset of ‘ripping’ or ‘tearing’ back, chest or abdominal pain. This pain is often very intense.
How is an aortic dissection?
Physical examination may find unequal pulses or blood pressure in the arms or lack of a pulse in a leg. The chest xray may show an enlargement of the aorta. The best tests for detection include a CAT scan or MRI of the aorta or a Transesophageal Echocardiogram. The choice of which test to use depends on which is more immediately available.
How is it treated?
Ascending aortic dissection is treated by immediate surgical repair of the aorta by a cardiothoracic surgeon. Descending aortic dissection is initially treated with aggressive blood pressure control but may eventually require surgery.
