Aortic Dissection

Acute aortic dissection is a life-threatening cardiovascular emergency that occurs when a tear develops in the innermost layer (intima) of the aorta, allowing blood to enter the medial layer and create a false lumen. This process can lead to rapid aortic rupture, end-organ ischemia, or death if not promptly diagnosed and treated. If aortic dissection is suspected, it is very important to get a quick diagnosis and begin treatment right away, as this can greatly increase the chances of survival. After treatment, patients need to keep their blood pressure well-controlled and have regular check-ups and imaging tests to stay healthy and prevent future problems.

Aortic dissection is typically classified by location and timing:

• Stanford Type A involves the ascending aorta and requires emergent surgical repair.
• Stanford Type B involves only the descending aorta and is often managed medically or with endovascular techniques, depending on complications.

Acute dissections are defined as occurring within 14 days of symptom onset and are associated with the highest risk of mortality.

The most common symptom of acute aortic dissection is sudden and severe chest or back pain, which may feel sharp, tearing, or pressure-like. However, the condition can also cause problems in other parts of the body if blood flow to organs is reduced, leading to symptoms like below :                     

• Pain that moves from the chest to the back, neck, jaw, or abdomen
• Shortness of breath
• Fainting or lightheadedness
• Weakness or numbness in one side of the body
• Difficulty speaking or vision changes
• Uneven pulses or blood pressure between the arms
• Cold or pale limbs (signs of poor blood flow)

High blood pressure (hypertension)

• The most common risk factor. Long-term high blood pressure can weaken the aortic wall.

Connective tissue disorders

• Conditions like Marfan syndrome or Loeys-Dietz syndrome can cause weakness in the aorta.

Genetic predisposition

• Family history of aortic dissection or aneurysm increases risk.

Aortic aneurysm

• A weakened and enlarged aorta is more prone to tearing.

Atherosclerosis

• Hardening of the arteries can contribute to vessel wall damage.

Trauma

• Severe chest injury, such as from a car accident, can trigger dissection.

Male gender and age

• Men over age 60 are at higher risk, though it can occur in younger people with genetic conditions.

Pregnancy (rare)

• Especially in women with underlying aortic conditions.

Control high blood pressure

• Keeping your blood pressure in a healthy range is the most important way to reduce stress on the aorta.

Take medications as prescribed

• If you have high blood pressure, aortic aneurysm, or other heart conditions, follow your doctor’s instructions carefully.

Regular check-ups and imaging

• If you have a family history of aortic disease or a known condition like Marfan syndrome, regular imaging (CT or echocardiography) can help detect problems early.

Avoid heavy lifting or intense straining

• These activities can raise your blood pressure suddenly and increase risk.

Stop smoking

• Smoking damages blood vessels and increases your risk of aortic and cardiovascular disease.

Maintain a heart-healthy lifestyle

• Eat a balanced diet, exercise moderately (as advised by your doctor), and maintain a healthy weight.

Know your family history

• If there is a history of aortic dissection or aneurysm in your family, speak to your doctor about screening.