heart and blood vessel disorders
Aortic Dissection
Introduction
An aortic dissection is an often fatal disorder in which the inner layer (lining) of the aortic wall tears and separates from the middle layer of the aortic wall. Most aortic dissections occur because high blood pressure causes the artery’s wall to deteriorate. People have sudden, excruciating pain, most commonly across the chest but also in the back between the shoulder blades. Doctors do imaging studies to confirm the diagnosis. People usually take medications to decrease blood pressure, and doctors do surgery to repair the tear or place stent grafts to cover the tear. (See also Overview of Aortic Aneurysms and Aortic Dissection ) The aorta is the largest artery of the body. It receives oxygen-rich blood from the heart and distributes it to the body through smaller arteries that branch off of it. The thoracic aorta, where most aortic dissection occurs, is the part of the aorta that passes through the chest. When the lining of the aorta tears, blood can push through the tear, separating (dissecting) the middle layer of the wall from the still intact outer layer. As a result, a new, false channel forms in the wall of the aorta. As the aortic dissection lengthens along the aorta, it can close off the points at which one or more arteries branch off from the aorta, blocking blood flow. Aortic dissections are three times more common among men and are more common among people of African ancestry (specifically African-American people) and less common among people with Asian ancestry. About three fourths of aortic dissections occur in people aged 40 to 70 years. Themost common causeof aortic dissection is Deterioration of the artery's wall because of longstanding High Blood Pressure None More than two thirds of people who have an aortic dissection have high blood pressure. Less common causesof aortic dissection include Hereditary connective tissue disorders, especially Marfan Syndrome and Overview of Heart Defects of the heart and blood vessels, such as coarctation (narrowing) of the aorta, patent ductus arteriosus (a connection between the aorta and the pulmonary artery), and defects of the aortic valve Atherosclerosis None Injury such as a car crash or fall causing a strong blow to the chest Aging, which can cause deterioration of the artery's wall Rarely, a dissection occurs accidentally when doctors are inserting a catheter into an artery (for example, during aortography or angiography) or doing surgery on the heart or blood vessels. In an aortic dissection, the inner layer (lining) of the aortic wall tears, and blood surges through the tear, separating (dissecting) the middle layer from the outer layer of the wall. As a result, a new, false channel forms in the wall. 