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Aortic Dissection

Rare Heart Condition Can Be Deadly

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Updated August 07, 2009

The aorta is affected in aortic dissection

The aorta can tear or burst

Photo © A.D.A.M.
Some people may experience aortic dissection as chest pain, and think it is a heart attack. Others may feel back pain and think they've pulled a muscle, or abdominal pain and think they have stomach flu. Aortic dissection, in which the aorta, one of the largest blood vessels in the body, starts to tear, comes on quickly and without warning. It occurs in about 2 out of every 10,000 people.

How aortic dissection 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 aortic 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: Aortic dissection is different than rips in the aorta made by trauma such as a gunshot wound or car accident.

Diagnosis

Diagnosis of aortic dissection 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

Sometimes aortic dissection is 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.

Sources:

"Aortic Dissection." Medline Plus Medical Encyclopedia. 12 Dec 2008. U.S. National Library of Medicine. 7 Aug 2009

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