If you experience these symptoms, you should call 911 or other emergency services immediately.
Do not drive yourself as time is
important and stress and movement should be reduced to a minimum. Do not try to
take pain medication or heart medication. Taking aspirin with aortic
dissections has had fatal consequences.
If you witness a person
become unconscious, call 911 or other emergency services and start cardiopulmonary
resuscitation (CPR). The emergency operator can coach you on how to perform
How is aortic dissection diagnosed?
Your doctor will
ask you questions about your symptoms, medical history, lifestyle, and family
medical history and perform 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.
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.
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 generally surgically treated.
- Dissections involving the
rest of the aorta are known as type B dissections. If there are no
complications, type B dissections are generally treated with
Initial emergency treatment and the treatment for type A
dissections are widely accepted, but treatment for uncomplicated type B
dissections remains controversial.
Initial emergency treatment
Treatment for aortic dissection should
be made 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.
Generally, 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
Medicine that aims to reduce pain and blood pressure
will be used and may include:
- Nitroprusside, which lowers blood pressure.
Your mean arterial blood pressure should be between 60 and 70 mm Hg. This
pressure normally guarantees a constant organ blood flow and minimizes the
pressure on the dissection. Nitroprusside causes a widening of the vessels
arteries and veins. The pressure in the whole body system is
- Beta-blockers, to lower your heart rate. Lowering the
blood pressure will lead to a natural heart reflex that increases heart
contraction and heart rate. This can increase the risk of rupture, so
beta-blockers will be administered. You should receive this before the
- Pain medicine. If the control of the hypertension
does not reduce your pain, strong pain medicines may be provided, including