Aortic dissection symptoms, emergency signs, diagnosis and treatment guidance.
Overview
What is aortic dissection?
- The aorta is the main blood pipe (vessel) that carries blood from the heart to the rest of the body
- An aortic dissection happens when there is a tear in the weak spot in the inner wall of the blood pipe
- Blood enters the tear and separates the inner and middle layers of the aortic wall
- This can reduce blood flow to important organs or cause the blood pipe to burst
- Aortic dissection is a medical emergency and needs immediate treatment, often surgery
How common is it in India?
Aortic dissection is not very common but cases are increasing
- It usually happens in men in their 60s and 70s
Why is it important?
If aortic dissection is not treated quickly:
- The aorta can burst (rupture)
- Blood supply to brain, heart, kidneys may stop
- This can be life-threatening within hours
Who is at risk?
Risk of aortic dissection is higher in people with:
- High blood pressure
- Fat or cholesterol buildup in the blood vessels (atherosclerosis)
- Swelling or bulge in the aorta (aortic aneurysm)
- Older than 50 years
- Smoking habit
- Inherited conditions that weaken blood vessels
- Heart valve problems
Signs and symptoms
Common symptoms
- Sudden severe chest or stomach pain
- Fainting or loss of consciousness
- Shortness of breath
- Sudden trouble speaking, seeing, or moving one side of the body (stroke-like symptoms)
- Leg pain or difficulty walking
Possible complications
Aortic dissection can lead to serious problems such as:
- Severe internal bleeding
- Damage to organs like the kidneys or intestines
- Stroke (blood flow to the brain is blocked or reduced)
- Leakage of the heart valve (Heart valves are like small doors inside the heart that help blood flow in the right direction)
- Fluid buildup around the heart that affects its pumping ability
Warning signs
Go to hospital immediately if you feel,1
- Sudden tearing chest or stomach pain
- Sudden severe breathlessness
- Difficulty speaking, seeing or moving
Tests to diagnose aortic dissection
Tests to diagnose aortic dissection include:
- Chest X-ray: Shows the heart, lungs and size of the aorta. It may show a widened aorta
- TEE (Transesophageal echocardiogram): Uses sound waves to create detailed pictures of the heart and aorta from inside the body
- CT(Computed tomography) scan: Uses X-rays to create detailed images of the chest and helps confirm an aortic dissection
- MRA (Magnetic resonance angiogram): Uses magnets and radio waves to create pictures of the blood vessels
Treatment
Treatment may include surgery or medicines, depending on the part of the aorta involved.
Type A aortic dissection (Upper part of the aorta near the heart)
Usually treated with emergency surgery
- The damaged part of the aorta is repaired or replaced with an artificial tube (graft)
- The heart valve may also be repaired or replaced if needed
- Medicines are given to lower blood pressure and reduce strain on the heart
Type B aortic dissection (Lower part of the aorta)
Often treated with medicines first
- Medicines help control blood pressure and heart rate
- Some patients may need surgery or a small tube called a stent to keep the blood vessel open
After treatment
- Blood pressure medicines may be needed for life
- Regular CT or MRI scans help check the aorta and blood vessels
Lifestyle tips to prevent aortic dissection
You can lower your risk of aortic dissection by keeping your heart and blood vessels healthy.
Control health conditions
- Keep blood pressure under control
- Manage blood sugar and cholesterol levels
- Take medicines regularly as advised by your doctor
Avoid smoking
- Do not smoke
- Ask your healthcare team for help to quit smoking
Follow a healthy lifestyle
- Eat healthy foods with less salt and more fruits, vegetables, and whole grains
- Exercise regularly (150 mins of moderate physical activity/ 75 mins of vigorous physical activity)
- Maintain a healthy weight
- Sleep 7-9 hours every night
Prevent injury
- Always wear a seat belt to reduce the risk of chest injury during accidents
Regular checkups
- Tell your doctor if there is a family history of aortic disease or weak blood vessels
- If you have an aortic aneurysm (bulging area in the aorta caused by a weak vessel wall), go for regular checkups and scans as advised
Myths and facts
Chest pain is always due to acidity or gas.
Sudden severe chest or back pain can be a sign of aortic dissection.
Only older people get aortic dissection.
Younger people with high blood pressure or inherited conditions can also be affected.
Medicines can treat every aortic dissection.
Some patients need emergency surgery or a stent procedure
Once treated, the problem never returns.
Lifelong follow-up and blood pressure control are important
Healthy-looking people cannot have aortic dissection.
Smoking, high blood pressure, and hidden blood vessel problems increase the risk.
FAQs
What is an aortic dissection?
Aortic dissection is caused by a tear in the inner wall of the aorta, the main blood vessel of the body.
What are the common symptoms?
Common symptoms include sudden severe chest, back or stomach pain, shortness of breath, fainting or weakness.
Is aortic dissection an emergency?
Yes. It needs immediate medical treatment.
How is it treated?
Treatment may include medicines, surgery or a stent procedure.
Can it be prevented?
Risk can be reduced by controlling blood pressure, stopping smoking, eating healthy and having regular checkups.
