During an aortic dissection the inner layer of your aorta tears, letting blood in where it usually doesn’t go. This causes the inner and middle layers to separate, or dissect. If the blood bursts through the outer wall of your aorta, it’s life-threatening and needs immediate repair.
Aortic dissection happens in places where your aortic wall is weak. Over time, high blood pressure can weaken your aortic tissue.
Sometimes the weakness is from a condition you’re born with that affects the strength or size of your aorta. Marfan syndrome is one example.
In rare cases it’s caused by a traumatic injury to the chest, as can happen in a car accident, for example.
There are two kinds of aortic dissections. The difference is where the dissection is located.
Type A. This is the more common of the two, and more dangerous. The tear happens in your upper aorta, which is also called the ascending aorta. It can extend into your abdomen, or in the area where your aorta leaves your heart.
Type B. This is when your lower, or descending, aorta tears. It, too, may reach into your abdomen.
Who’s At Risk
Aortic dissections most often happen in men between the ages of 60 and 80. In fact, men are twice as likely to have an aortic dissection as women. Other things that make an aortic dissection more likely include:
- Hardening of the arteries, or atherosclerosis
- High blood pressure, or hypertension, that isn’t being controlled
- A pre-existing bulging, or weakened, artery
- A bicuspid aortic valve (a valve with two leaflets)
- When the aorta is narrowed at birth, called aortic coarctation
Certain genetic diseases also seem to increase your odds of having an aortic dissection, including:
- Turner’s syndrome
- Marfan syndrome
- Connective tissue disorders, such as Ehlers-Danlos syndrome and Loeys-Dietz syndrome
- Some inflammatory conditions, such as giant cell arteritis and syphilis
The most common symptoms are:
- Shortness of breath
- Loss of consciousness
- A weaker pulse in one arm than the other
- Sudden, severe upper back or chest pain (often described as a “tearing” sensation from the neck down the back)
- Mild neck, jaw, or chest pain
- Sudden trouble speaking
- Loss of vision
- Paralysis or weakness on one side of the body, much like a stroke
- Tingling, numbness, or pain in the toes and/or fingers
When to Call 911
Stay as calm as possible, though. Sometimes these symptoms don’t mean there’s a serious medical problem. They can happen for other reasons. But you need to find out immediately, so make the call
If your doctor finds an aortic dissection early, you have a greater chance of being able to be treated. Your doctor will take X-rays and scans to get a view of your heart. He may also do blood tests and decide to do surgery, which involves removing the dissection and “rebuilding” your aorta with a plastic tube, called a graft.
Treatment often involves medications. These can include beta blockers and sodium nitroprusside (Nitropress), which will help lower your blood pressure and heart rate. You may have to take these for the rest of your life.
Your doctor may also ask for follow-up scans to monitor your heart, and prescribe medicine to relieve pain.
Can You Prevent It?
The best way to lower your odds of having an aortic dissection is to schedule an annual visit with your doctor, so he can check your heart. You can also:
Talk to your doctor. Tell him about any genetic conditions you have. If they raise your chances of aortic dissection, he may recommend you take blood pressure medications to help prevent it.
Control your blood pressure. If you have high blood pressure, keep up with your medicine, diet, and exercise to manage it. You may also want to buy a portable blood pressure measuring device at a pharmacy or online, or check your pressure at grocery stores or pharmacies that have machines.
Don’t smoke. If you do, plan to quit. Many people try several times before they kick the habit for good. That’s OK -- keep trying! Tell your doctor, who can look into methods that will help you quit.
Limit how much salt you get -- check food labels.
Wear a seat belt. It can lower your risk of a traumatic chest injury in case of an accident.