A tear begins
Think of blood vessels as tubes with several layers in the tube walls. In aortic dissection, the inner layer of the aorta begins to tear. Blood collects between the layers. The tear and blood may cause the other layers to tear, and the tears may eventually burst. Not all dissections burst, but if one does it is almost always fatal.
Causes of dissection
Men are three times more likely than women to experience aortic dissection. Approximately 75% of cases happen in people aged 40-70 years. There are a number of reasons why the aorta might be weakened or predisposed to tearing:
- Certain diseases, among which are Marfan syndrome, Ehlers-Danlos syndrome, polycystic kidney disease, Turner syndrome, syphilis, and homocystinuria.
- Crack cocaine use
- Pregnancy
- High blood pressure
- Family history of aortic dissection.
Aortic dissection is different than rips in the aorta made by trauma such as a gunshot wound or car accident.
Diagnosis
Diagnosis may be difficult, since the pain experienced may be mistaken for other disorders. Aortic dissection may cause a heart attack, which may hide its symptoms. In about 10% of cases there is no pain at all. A dissection may cause fainting, confusion, shortness of breath, arm or leg pain or numbness, and blood pressure changes. X-ray, CT scan, or MRI can reveal the dissection.
Treatment
Some dissections are mild and can be treated by controlling blood pressure. Most dissections, though, require surgery to repair the tear. If the tear ruptures, however, even emergency surgery may not be able to save the person. Actor John Ritter was working on a TV soundstage when he suddenly became ill; despite surgery to repair an aortic dissection, he died that very evening. He was 54 years old.
Information for this article was taken from:
- MSNBC. Actor John Ritter dies at age 54. September 12, 2003.
- Wiesenfarth, J. (2002). Aortic dissection. eMedicine, accessed at http://www.emedicine.com/emerg/topic28.htm
