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Aortic aneurysm and aortic dissection

What is Aortic aneurysm and aortic dissection?

The aorta is the biggest artery in the body. It originates from the heart and supplies blood to the whole body via branches of arteries. Diseases of the aorta can lead to abnormal narrowing and dilation of the arteries. These diseases include aortic aneurysm and aortic dissection.

Aortic aneurysm refers to the abnormal dilation (swelling) of the aorta. The dilation of the aorta’s wall may lead to the aorta being ruptured, which can lead to massive internal bleeding and severe pain.

Aortic dissection refers to a tearing in the wall of the aorta. The dissection causes the layers of the wall of the aorta to come apart as blood is flowing between the layers. Rapid blood loss can occur if the aorta is completely torn apart by the dissection. This is considered a medical emergency.

An aortic dissection can affect the blood supply to various parts of the body, leading to:

  • Damage to the aortic valve (aortic regurgitation)
  • Organ damage (including kidneys, intestines, heart, brain)
  • Stroke, which may lead to paralysis
  • Death

Causes

These conditions are commonly associated with uncontrolled high blood pressure or any of the following conditions that lead to the weakening of the blood vessels wall:

– Chronic high blood pressure, which affects the aortic tissue, making it more susceptible to tearing

– Congenital conditions (conditions that you are born with) that weaken and dilate the aorta’s wall (including Marfan’s syndrome and bicuspid aortic valve)

– In rare instances, motor vehicle accidents might lead to aortic dissections due to traumatic injury to the chest

– Other potential causes include:

  • Ageing
  • Drug use
  • Pregnancy

Symptoms

Most aortic aneurysms result in no symptoms

Symptoms of aortic dissection include:

  • Abdominal pain
  • Fainting
  • Intense ripping pain in your chest or upper back
  • Numb or cold extremities
  • Stroke
  • Sweating

Treatment

Aortic aneurysm:

  • If you have no symptoms and your aneurysm is small, the doctor can suggest a ‘watch-and-wait’ approach with regular monitoring of the size of your aneurysm
  • If your aneurysm is big enough or if it is growing more than 1 cm a year, the doctor may recommend aortic surgery

Aortic dissection:

  • Oral and intravenous medications can help control your blood pressure and heart rate while the aorta is healing
  • The diameter of the aorta can be monitored to help prevent enlargement or rupture
  • If the dissection affects the initial part of the aorta, the doctor may suggest surgery because there may be risk to your heart and brain arteries

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