Dissecting aortic aneurysm

Dissecting Aortic Aneurysm
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Severe chest or back pain, syncope, shortness of breath
Complications	Aortic rupture, organ ischemia, stroke
Onset	Sudden
Duration
Types	N/A
Causes	Hypertension, connective tissue disorders, trauma
Risks	Hypertension, atherosclerosis, bicuspid aortic valve
Diagnosis	CT scan, MRI, Transesophageal echocardiogram
Differential diagnosis	N/A
Prevention	N/A
Treatment	Surgery, medication
Medication	N/A
Prognosis	Variable
Frequency
Deaths	N/A

Overview

A dissecting aortic aneurysm is a serious condition in which there is a tear in the inner layer of the aorta, the large blood vessel branching off the heart. Blood surges through this tear, causing the inner and middle layers of the aorta to separate (dissect). If the blood-filled channel ruptures through the outside aortic wall, aortic dissection is often fatal.

Pathophysiology

The aorta is composed of three layers: the intima (inner layer), the media (middle layer), and the adventitia (outer layer). In a dissecting aortic aneurysm, a tear in the intima allows blood to enter the media, creating a false lumen. This can lead to a propagation of the dissection along the aorta, potentially compromising blood flow to vital organs.

Causes

The primary causes of dissecting aortic aneurysm include:

• Hypertension: High blood pressure can cause stress on the aortic wall, leading to a tear.
• Connective tissue disorders: Conditions such as Marfan syndrome and Ehlers-Danlos syndrome can weaken the aortic wall.
• Trauma: Blunt chest trauma can result in aortic dissection.
• Atherosclerosis: Plaque buildup can weaken the aortic wall.

Risk Factors

Several factors increase the risk of developing a dissecting aortic aneurysm:

• Age: Most common in people in their 60s and 70s.
• Gender: More common in males.
• Family history: Genetic predisposition can play a role.
• Bicuspid aortic valve: A congenital heart defect that can increase risk.

Symptoms

Symptoms of a dissecting aortic aneurysm can include:

• Sudden severe chest or upper back pain, often described as a tearing or ripping sensation.
• Loss of consciousness (syncope).
• Shortness of breath.
• Weakness or paralysis on one side of the body, similar to a stroke.
• Difficulty speaking or loss of vision.

Diagnosis

Diagnosis of a dissecting aortic aneurysm typically involves imaging studies such as:

• Computed tomography (CT) scan: A CT scan with contrast is often the first choice for diagnosis.
• Magnetic resonance imaging (MRI): Provides detailed images of the aorta.
• Transesophageal echocardiogram (TEE): An ultrasound probe is inserted into the esophagus to get a close look at the aorta.

Treatment

Treatment depends on the location and extent of the dissection:

• Surgical intervention: Emergency surgery may be required to repair the aorta.
• Medication: Blood pressure control is critical. Beta-blockers and other antihypertensive medications are used to reduce stress on the aortic wall.

Prognosis

The prognosis for a dissecting aortic aneurysm varies. Early diagnosis and treatment are crucial for survival. Without treatment, the condition can be rapidly fatal.

Prevention

Preventive measures include:

• Controlling blood pressure.
• Regular monitoring for those with connective tissue disorders.
• Lifestyle changes such as quitting smoking and maintaining a healthy diet.

See Also

• Aortic aneurysm
• Hypertension
• Marfan syndrome

External Links

• [American Heart Association]
• [National Heart, Lung, and Blood Institute]