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Aortic Dissection - Topic Overview

How is aortic dissection diagnosed?

Your doctor will ask you questions about your symptoms, medical history, lifestyle, and family medical history and do a physical exam. He or she may ask if you have been hit hard in the chest or been in an automobile accident. Several specialists may see you.

Physical exam

Your doctor will listen to your heart sounds with a stethoscope, take your pulse and evaluate your circulation, and evaluate your neurological status (nerve and brain function). As the symptoms of aortic dissection mimic many other conditions, you may need several tests.

Tests

If you have an aortic dissection, you may need:

How is aortic dissection treated?

The treatment of aortic dissection depends in part on where the dissection is located:

  • Dissections involving the aorta where it goes up from the heart (with or without the arch) are known as type A dissections and are typically treated with surgery.
  • Dissections involving the rest of the aorta are known as type B dissections. If there are no complications, type B dissections are typically treated with medicines.

Initial emergency treatment

Treatment for aortic dissection should be started immediately following the diagnosis. The goal of initial emergency treatment is to relieve pain and to reduce the blood pressure on the dissection (reduction of the pulsatile load). This helps prevent additional bleeding and reduces the risk of a rupture.

Typically, you are put immediately in an intensive care unit (ICU) or taken to the operating room. Your doctor will continuously monitor and control your blood pressure, pulse, and heart activity.

Treating type A dissections

Typically, the first line of treatment for type A dissections (dissection of the aorta involving the ascending aorta) is surgery.

The goal of the operation is to prevent death due to bleeding and to reestablish blood flow into the extremities and inner organs (if branches of the aorta are involved in the dissection process).

In this open-heart procedure, your chest is opened and the surgeon removes the part of the aorta where the tear is found. The portion of the aorta removed can be replaced with a man-made graft. Another approach uses a similar graft that is placed inside the aorta. In this approach the ascending aorta is not replaced but internally reinforced.

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WebMD Medical Reference from Healthwise

Last Updated: February 22, 2012
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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