Aortic Dissection

In the 10 years of my healthcare career, I’ve never taken care of a patient who is recovering from an aortic dissection. Though aortic dissections are very rare, healthcare professionals understand that aortic dissections are a serious matter. Every second counts when trying to save a patient whose life is threatened by internal bleeding. Below, I have described what an aorta is, its purpose, the causes of an aortic dissection, symptoms, treatment, and the survival rate.

What is the aorta?

● The aorta is a major cane-shaped artery that branches off the left lower chamber of the heart.
● The purpose of the aorta is to carry oxygenated blood away from the heart to the major organs of the body: the brain, lungs, kidneys, abdomen, and lower extremities.

Causes of an aortic dissection

● An aortic dissection occurs when a tear develops in the inner layer (lining) of the aorta, causing the blood to fill the middle layer, and further filling and extending the tear, thereby separating the aorta.
● An aortic dissection can be caused by high blood pressure, aneurysms, plaque buildup in the arteries (atherosclerosis), family genetics, traumatic injuries from a major car accident or from a high fall, and connective tissues diseases such as Marfan syndrome.

Symptoms

Aortic dissection is a major medical emergency that requires immediate treatment. If anyone exhibits these signs or symptoms, please call 911 immediately.
● Symptoms may include acute chest pain. People may complain of sharp, stabbing, ripping, or tearing pain. The pain can occur below or behind the sternum (breastbone) and radiates to the back or underneath the shoulder blades
● The pain can often change locations and radiate to the neck, arms, jaw, abdomen, and hips
● People may show the following signs: pale (Caucasians) or ashy/blue/grey (Africa-Americans or Latinos) skin complexion
● weak or rapid pulse
● shortness of breath
● difficulty breathing while lying flat
● increased anxiety
● fainting
● increased dizziness
● and heavy sweating

All these signs are related to the decrease in blood flow to the rest of the body.

Treatment

● If the aorta has not ruptured, the dissection can be managed with surgery and medication to
lower the blood pressure.
● Survivors will be on blood pressure medications for the rest of their life and will require constant
follow-up with a cardiologist to monitor the size of the aorta and blood pressure medications.
Survival Rate
● The prognosis depends on the timeliness of the diagnosis in the ER, the size of the dissection,
and the possibility of a ruptured aorta.
● According to Dr. Wiesenfarth, “Aortic dissection is the most common catastrophe of the aorta,
2-3 times more common than rupture of the abdominal aorta.
● When left untreated, about 33% of patients die within the first 24 hours, and 50% die within 48
hours.
● The 2-week mortality rate approaches 75% in patients with undiagnosed ascending aortic
dissection” (1). Unfortunately, an aorta rupture may result in death.