Discussion of Aortic Dissection

Heart Disease. Those two words often conjure images of an elderly man clutching his chest in a fit of pain and subsequently succumbing to a heart attack. Those two words describe the leading cause of death in Americans--nearly 25%1. Unfortunately, many specific heart problems fade away and fall under the umbrella of only two words. This research paper will discuss one of those heart problems, aortic dissection, in much more detail, than just two little words.

The aorta is the largest artery in the body, responsible for the transfer of oxygenated blood from the heart to every organ of the body. Understandably, any disruption in the integrity of the aorta could have catastrophic consequences. An aortic dissection occurs when a tear in the inner layer of the aorta develops. As the tear expands, blood will eventually begin to spill out of the tear and continue down the aorta in between the inner layer and outer layer. As the inner and outer layers begin to separate from each other, they develop into what is called a true and false lumen. An aorta can dissect in various ways. Those different types of dissection are then classified as Type A, B and Type I through III. Type A involves the ascending aorta. Type B does not involve the ascending aorta2. Type I involves the entire aorta, Type II involves only the ascending aorta, and Type III originates in the descending aorta and extends distally and does not involve the ascending aorta or arch.2 Dissections that originate in the descending aorta and then progressively dissect proximally are still considered Type III.

There are several different causes of an aortic dissection. Trauma is a major cause of an aortic dissection, specifically blunt trauma, such as a chest hitting a steering ...

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...ers. Numerous signs and symptoms occur with an aortic dissection, making it very difficult to diagnose. Chest x-ray and chest and abdomen CT angiograms are the two most common tests performed to confirm a diagnosis, with CT angiogram being the modality of choice. If the patient survives the initial onset of an aortic dissection long enough surgical repair may be done. Surgical repair is very risky and does not have a high success rate, however, if surgery proves to be successful a patient’s prognosis greatly increases after 30 days. Perhaps the next time one is faced with the familiar imagery of a man grasping his chest and collapsing due to “heart disease,” instead of assuming the man suffered from the usual heart attack, one will remember that there are countless conditions that heart disease encompasses, and that aortic dissection remains one of the most deadly.