Aortic dissection is a serious condition that can lead to to instant death.
To get more insight into what happens when you get an aortic dissection and how to prevent one, we turned to Fernando Fleischman, MD, assistant professor of surgery and the co-director of the USC Comprehensive Aortic Center at Keck Medicine of USC.
Dr. Fleischman explains that an aortic dissection is a tear in between one of the three walls of the aorta. The aorta is the main artery of the body that supplies oxygenated blood to the circulatory system. It passes out of the heart from the left ventricle and runs down in front of the backbone.
When this happens, blood enters an area that it should not be. This is usually caused by high blood pressure. High blood pressure is considered anything above 130.
This is a deadly problem, the patient is at risk of having their aorta get bigger and/or rupture, which leads to death.
Anyone can be affected.
Aortic dissections affect people of all ages, but usually tend to start in the mid 30s to the late 80s.
Many people are under the impression that dissections are related to heart disease, but they aren’t.
The number one presenting sign is a rip-roaring chest pain that radiates to your back. People present symptoms in different ways, but the number one symptom starts with chest pain. The pain tends to be acute and severe, with constant chest pain until you are taken care of.
There are two types of aortic dissections:
• Type A (Ascending)
• Type B (Descending)
Type A dissections come right out of the heart.
The tear from Type A dissections can cut off the coronaries (the arteries that surround and supply the heart). It can also cause a stroke and cut off the carotids (the two main arteries that carry blood to the head, neck and brain and their two main branches).
Type B dissections are descending thoracic aorta dissections. The thoracic aorta is a part of the aorta located in the thorax.
Type B dissections can get aneurysmal, which is when the artery becomes excessively enlarged due to the weakening of the artery wall. They can also cut off blood flow to vessels of the abdomen or legs. They can also become big and risk rupturing, which causes death.
If a patient is diagnosed with an aortic dissection, chances are they have been admitted into an emergency room. The problem is that the patient only has a couple hours to live, so action needs to be taken immediately.
The USC Cardiovascular Thoracic Institute at Keck Medicine of USC has a rapid transport system that brings patients to our facilities quickly. We handle more aortic dissections than any other medical enter in Southern California and are staffed with a fantastic team.
Once the patient arrives and depending on which type of dissection they have their route of treatment is decided.
Type A dissections require a major operation. The patient needs to be cooled down to prevent any blood flow and the cardiac surgeon has to replace the actual aorta with a plastic tube so blood can go back to the brain.
Type B dissections are handled with a team approach. If the dissection happens before the artery branches off, it can be treated with a stent, which is a round device that diverts blood flow within the artery, and other blood pressure controls. The other option is medical therapy, which is why a team approach is necessary.
How to prevent an aortic dissection:
Manage your blood pressure. To manage your blood pressure, it is recommended to diet and stay away from salty foods with high sodium.
When to get checked:
If any of the following sounds like you,
• A family history of aneurysm or dissections
• Blood pressure above 130 that has been uncontrolled for years
• High blood pressure and chest pain of any kind
• Smokers who have a history of aneurysm and now have chest paint
We recommend for you to come to Keck Medicine of USC to have yourself checked out. Aortic dissections can be prevented if patients maintain their blood pressure, and if they have aneurysms, to have them watched by our team. Once an aneurysm gets to a certain size, it has a higher risk of rupture. Our goal is to get these patients early so we can monitor their ascending aortas.
To learn more about the USC Comprehensive Aortic Center, visit http://aortic.keckmedicine.org/. To schedule an appointment, call (800) USC-CARE (800-872-2273) or visit http://aortic.keckmedicine.org/request-an-appointment/.