Aortic dissection is a life threatening condition involving the main artery of the body. This can involve the artery in the chest or abdomen. The branch vessels of the aorta can also be involved.
In aortic dissection, blood flows between the inner and middle layer of the aorta because of a tear in the inner wall.
Patients present with various symptoms like chest pain, abdominal pain, stroke like symptoms in addition to others.
Aortic dissection is often diagnosed using CT scans. This is a life threatening condition which needs prompt diagnosis and treatment.
What is aortic dissection?
A tear in the inner layer of the aortic wall causes blood to extend between the inner and middle layers of the aorta. This causes a separation of the layers (dissection). A second channel forms in the aorta as a result of blood extending between the inner and middle layers.
Symptoms of aortic dissection
This depends on where the dissection is and if there are any complications like involvement of branch vessels.
Some common symptoms include: Sudden or severe chest or abdominal pain, fainting, dizziness, stroke like symptoms like losing function on one side of your body, loss of vision.
Risk factors for Aortic dissection
High blood pressure is one of the main risk factors. This causes damage to the aortic wall and makes one susceptible to aortic dissection.
Other risk factors include: atherosclerosis, aortic valve disease, connective tissue diseases like Marfan syndrome, family history of dissection, trauma to the chest, older age.
Aortic Dissection In The Chest
Aortic dissection in the chest is split into two types. Stanford type A aortic dissection involves the aorta as it comes out of the heart (ascending aorta). This is life threatening and needs emergency surgery.
Stanford type B aortic dissection involves the aorta further from the heart (descending aorta). This can extend into the abdomen. Surgery is sometimes needed when the dissection reduces blood supply to organs.
Aortic Dissection In The Abdomen
Aortic dissection in the abdomen can extend from the chest or occur in the abdomen. The dissection can involve branch vessels that feed organs or the legs. This can cut off the blood supply.
What does aortic dissection look like on a CT scan?
Aortic dissection will show the aorta split into two channels. One being the natural channel where blood flows to the body and the other representing the false channel. This is blood extending between the inner and middle layers of the aorta.
What causes aortic dissection?
Aortic dissection is most common in elderly patients with high blood pressure. A weakness of the aortic wall from genetic factors and chronic damage can lead to a tear and dissection.
Complications of aortic dissection
Aortic dissection can lead to strokes, damage to internal organs, blood in the sac around the heart preventing it from functioning, and death. Patients can have clots migrate to other parts of the body. Aneurysms can develop. The aorta can rupture.
Is aortic dissection dangerous?
Aortic dissection is a life threatening condition which needs prompt treatment.
Aortic dissection treatment
Aortic dissection is treated with immediate surgical repair for Stanford type A dissection invoking the aorta closest to the heart. Complicated Stanford type B is also treated surgically. Blood pressure control is pursued for other types of dissections.
Aortic dissection on CT: summary
Aortic dissection is a tear of the inner wall of the aorta which allows blood to extend between the layers of the wall. The blood vessel is essentially split into two.
The condition is life threatening and requires prompt diagnosis. This is often done with CT scans which will show two channels in the aorta. Treatment can be both medical and surgical when the aorta closest to heart is involved.