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Normal |
Abnormal |
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The aorta
is the large artery that carries blood from the heart to the
rest of the body. Anatomically, it arches over the heart,
down the back of the chest cavity, into the abdomen. Though
the wall of the aorta is thick, a tear may occur in the
wall. Tears generally start from the inside and burrow
downward. A tear in the aorta is called an aortic
dissection. Aortic dissections are classified into two
types, based on the location of the tear: If the tear is
high in the aorta (ascending aorta and the arch) it is
called Type A; lower (descending aorta), it is called Type
B.
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- Sudden onset of severe chest pain
- Pain radiates down arms or into
neck
- Sweating
- Loss of consciousness
- Shortness of breath
- Weakness
- Ripping/tearing pain in the back or
chest
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- A tear in the internal layer of the
aorta that extends down the wall, creating a false lumen.
- Possibly, injuries during
catheterization
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- Diminished pulses in wrists and/or
legs/feet
- Wide pulse pressure
- Low or High Blood Pressure
- Heart murmur
- Lung crackles
- Electrocardiogram may
show
left ventricular hypertrophy. It may show myocardial
ischemia (decreased blood to heart) if dissection extends
into coronary blood vessels.
- Imaging:
- Chest X-Rays show
abnormal aortic contour or widened mediastinum (center
cavity of chest) --
a widened area where the aorta is normally
narrower
- CT scan
- MRI
- Angiography (dye is injected into the aorta and X-Rays taken)
- Transesophageal Echocardiography (ultrasound of heart
done by passing a scope into the
esophagus)
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- Long-standing High Blood Pressure
- Age
- Bicuspid aortic valve
- Aortic coarctation
- Pregnancy
- Marfan's Syndrome (a
genetic disorder that results in a defect in components that
make up wall structure of the aorta)
- Ehlers-Danlos syndrome
- Cardiac surgery
- Trauma to the chest
- Cocaine
abuse
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- Intravenous beta blockers decrease
shear force and blood pressure
- Intravenous nitroprusside to lower blood
pressure
Replacement of torn aorta with an artificial
graft
- Note: Type A dissections nearly always need surgery,
whereas Type B is generally managed with
medications.
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You need
emergency medical treatment. The death rate for untreated
aortic dissection is 20% in the first day, and 90% over 3
months.
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One of the major causes of aortic dissection is untreated High Blood Pressure.
Proper monitoring and use of blood pressure medications will
prevent aortic dissection in most
cases.
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