Aortic Dissection: Your Chest (Or Gut Pain) Could Be A Critical Health Emergency

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If you are having abdominal pain and unusual anxiety, this could be the result of developing an aortic dissection, and you will need emergency medical care immediately. This happens when a tear occurs in the innermost layer of your aorta (the main artery that carries blood from the heart), and then blood rushes in, causing the middle layers to separate. This condition can be fatal if the outside arterial wall ruptures, so if it is detected and treated early, your chances of survival are much greater.

Signs and Symptoms

Aortic dissection is relatively rare, but needs to be ruled out if you are experience certain symptoms that occur with an abrupt onset. You may feel like you are having a heart attack, and one indicator is a blood pressure difference from one arm to the other. A chest X-ray will probably show a widening of your aorta. 

This condition reduces blood flow to the body so you could experience some or all of the following signs and symptoms:

• An unusual sense of impending doom or anxiety
• Sharp, stabbing, or tearing chest pain
• Pain in a shoulder, your neck or jaw, your hips, or abdomen
• Arm and/or leg pain
• Dizziness, nausea, and vomiting
• Trouble with breathing when lying down
• Difficulty swallowing
• Pallor and heavy sweating

The Cause

If the aorta is weakened due to a health condition or an accident, it may tear internally and this will create two blood channels. One collects blood, while the other channel continues to have blood flow that travels on. The still blood channel will grow to cause a bulge(s), which restricts blood flow to the aortic branches. An aneurysm or several aneurysms could form in the bulge(s) to further complicate the problem.

Aortic Dissection can cause severe internal bleeding, stroke, heart valve damage, and also damage to the kidneys or other vital organs.

Susceptible Persons

This condition could happen to anyone, but most often occurs in older males. There is increased percentage of cases during the yearly flu season which indicates influenza could be a factor, and catastrophic accidents causing blunt chest trauma can also cause this event to occur.

Health conditions that can lead to this event include:

• Chronic high blood pressure
• Atherosclerosis
• Pregnancy
• Aortic narrowing (coartation)
• Connective tissue disorders
• Heart surgery/procedure
• Blood vessel swelling due to syphilis or arteritis,
• Bicuspid aortic valve problems
• Genetic disposition to this condition

Diagnosis and Treatment

Since early diagnosis is vital, a doctor will confirm it with a CT scan, an echocardiogram to look at the heart, and/or a magnetic resonance angiogram (MRA) to see images of the blood vessels. Treatment could involve:

• Surgery to remove damaged aortic material and to restore function to the aorta with a synthetic graft or stents (tiny mesh tubes used to produce a scaffolding for support of the repair).
• Surgery to reconstruct your damaged heart valves.
• Medications to lower your blood pressure and to slow your heart rate before surgery.
• Periodic testing, and follow-up afterwards.
• Regular prescription of blood pressure medication taken daily thereafter.

To lower your risk of developing an aortic dissection, you should avoid smoking, maintain a healthy weight, get regular exercise, and inform your doctor of family members who have had one, or similar problems. If you have symptoms of an aortic dissection, go immediately to the nearest emergency room. 

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7 January 2015