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Aortic dissection is the separation of the aortic membranes, causing blood to fill the channel between the membranes. The human arterial system resembles a system of pipes, each of which is made of several layers (usually three: inner, middle and outer). If the blood pressure flowing through the pipes is too high, the inner layer may rupture.
Aortic dissection – causes
Until the inner layer is torn, blood flows between the remnants of the damaged layer and the middle layer and damages it. This is how aortic dissection occurs. If the outer layer is also damaged over time, the entire vessel breaks. The blood in it flows out. We are then talking about bleeding. Over time, the lumen of the entire artery may widen, a condition known as an aneurysm.
Factors that increase the likelihood of aortic dissection include:
- hypertension,
- Marfan’s syndrome – hereditary abnormalities of the collagen structure, which include, among others, in the walls of arterial vessels,
- aortic coarctation – a congenital heart defect,
- male gender and age 50-60 years,
- pregnancy – III trimester.
As much as 60-70% of aortic dissecting aneurysms are located in the ascending aorta (i.e. in the segment of this vessel closest to the heart). The aortic arch is affected in 10-25% of cases.
Aortic dissection – symptoms
Most often, people with aortic dissection aneurysm experience pain in the chest or back. If the aorta ruptures, the pain is sudden and severe. The symptoms may be similar to those of a heart attack. Pain is sometimes wandering. It follows the direction of the delamination of the vessel, i.e. it starts in the chest and then moves towards the neck. Usually it is accompanied by drenching sweats, feeling anxious, vomiting; there is circulatory failure (cardiogenic shock).
For people with aortic dissecting aneurysm, the blood pressure measured for the right and left hands may be different. In peripheral arteries, the pulse is asymmetrical or it appears on only one side (e.g., it can be felt in only one radial artery).
Aortic dissecting aneurysm is a direct threat to life. In people who do not undergo surgery, its mortality rate exceeds 50%.