The aorta, which is the largest artery in the body, provides blood pumping firstly to the heart and the brain, and then to other vital tissues and organs after leaving the heart.
What is Aortic Tear?
3 cm. Aortic dissection is defined as rupture of an aortic vessel with a diameter of its own. Aortic dissection, which is seen in 5 to 30 per 1 million worldwide, is mostly seen in people over 40 years of age with hypertensive, that is, high blood pressure disease. This condition, which is 2-3 times more common in men than in women in the same age group, requires rapid diagnosis and treatment.
Aortic dissection characterized by sudden onset of back pain or pain in the chest area; It can have serious consequences such as heart attack, multiple organ failure and even death. Aortic dissection occurs when the aortic vessel ruptures for different reasons and blood fills into the wall.
The aorta is physically composed of 3 separate layers. Tearing may occur in the inner layer through which blood passes due to different reasons. The blood passing through the aorta at high pressure causes the area of the torn inner layer to open and the blood to pass into the middle layer. As a result of this situation, which causes the inner and outer layers of the aorta to separate from each other, the blood in the aorta begins to flow from the aortic walls to the cavities in the body. This can lead to sudden shock and death.
An abnormality that develops in the aorta, which carries blood to the whole body in a healthy way, can cause damage to the whole body. Therefore, prompt diagnosis and immediate intervention are extremely important in the presence of aortic dissection. Before moving on to the symptoms of aortic dissection, "What is aortic rupture?" It is necessary to answer the question.
The aorta is the largest artery coming out of the heart. After exiting the heart, the aorta first moves towards the neck region and then curves downwards from the thoracic cavity to the abdomen. It divides into two in the abdomen, at the level of the lumbar spine. Dividing into many branches, it nourishes all vital tissues and organs in the body, especially the heart and brain. Consisting of three interlocking layers, the aorta is structurally stronger than any other vessel. is durable and flexible. The destruction caused by various reasons in the innermost layer through which the blood passes, causes the blood to enter the middle layer.
Due to the pressure of blood being pumped into the aorta, the inner and outer layers of the vessel are separated from each other and the blood spreads here. As a result, blood begins to flow towards the body cavity. Aortic rupture, or aortic dissection, as it is called in medical language, is a cardiovascular disease that requires prompt diagnosis and treatment, with a high probability of death. Aortic dissection usually has a poor prognosis and may result in sudden shock and death. In the disease, which is characterized by severe chest pain that develops suddenly, the person describes the pain as tearing. This rare disease is 2-3 times more common in men than in women.
There are approximately 350 cases of aortic rupture in Turkey every year. Tears in the aorta are examined in two different ways: Stanford classification and DeBakey classification. There are two different types in the Stanford classification, type A and type B. Type A aortic dissection is used to describe tears that occur in the ascending aorta, while type B aortic dissection is used to describe tears that occur in the descending aorta. In the DeBakey classification, there are 3 different types as type 1, 2 and 3. Type 1 is used to describe ruptures in the ascending aorta, aortic arch, and descending aorta, type 2 only in the ascending aorta, and type 3 only in the descending aorta. Today, mostly type 1, type 2 and type 3 types in DeBakey classification are used.
What Causes Aortic Tear?
Aortic dissection is a rare but very serious cardiovascular disease that can result in loss of life. High blood pressure is the most important cause of aortic rupture. Uncontrolled hypertension leads to increased intravascular pressure. This, in turn, may cause aortic rupture by increasing the load on the aorta over time. Another common cause of aortic rupture is arteriosclerosis.
In the disease, which is defined as atherosclerosis in the medical language, plaque accumulation occurs in the vessels of the person. This causes the vein to lose its elasticity. Aortic rupture may also occur due to sudden trauma such as a traffic accident. also a. Underdevelopment of a part of the aortic vessel, structural differences in the vessel, having undergone an operation related to the aortic vessel, connective tissue diseases and some genetic factors may lead to aortic dissection.
The risk of aortic rupture is higher in people with Marfan disease, bicuspid aortic valve (BAC) disease, and congenital aortic stenosis, which is one of the diseases that negatively affect the production of connective tissue. Depending on the changing hormonal order during pregnancy, differentiation can be seen in the aorta of the person. This may also cause aortic dissection.
What are the Symptoms of Aortic Rupture?
Approximately 40% of aortic dissection cases result in sudden death. For the remaining 60%, the chance of cure differs depending on the type and extent of the aortic dissection and how quickly it is brought to the hospital. Some of the common symptoms in the presence of aortic dissection can be listed as follows:
- Pain in the form of tearing in the chest area,
- Pain just behind the breastbone,
- The pain is radiating
- Dyspnea (Dyspnea),
- Fainting (Syncope),
- Increased or decreased blood pressure,
- Heart palpitations (Tachycardia),
- Blood pressure difference in arms and legs,
- Hoarseness,
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- Sweating,
- Weakness.
Can Aortic Tear Be Prevented?
Aortic rupture can be prevented by reducing the risks. Controlling high blood pressure is essential in preventing aortic rupture and many other health problems. It may be recommended to quit smoking and exercise regularly. People aged 65 to 75 should have regular health screenings, even if they have no symptoms. In the presence of a problem with the aorta, the person should definitely go to the doctor's control regularly.
How to Diagnose Aortic Tear Is it placed?
If the person is brought to the emergency room with the symptoms of aortic rupture, the physician will have information about the type of rupture by performing a CT scan. In addition, additional diagnostic methods such as angiography, MR angiography, and transesophageal ECO (TEE) are used. After the diagnosis of aortic rupture is clarified, treatment is started quickly.
How to Treat Aortic Tear?
Treatment of aortic dissection is done with medication, endovascular or surgical methods. Depending on the clinical findings of the person, the treatment can be done with medication. Primarily, the heart rate is reduced without disturbing the blood flow and the spread of the aortic dissection is prevented. High blood pressure is controlled. Endovascular treatment can be defined as placing a stent on the patient. By entering from a different vein, the dissection area in the aorta is reached. The stent, defined as a stent graft, is placed into the vein.
Thus, blood passes through the stent in the vessel and prevents damage to the vessel. In cases where medicated treatment is insufficient or unsuitable for stenting, surgical method is used. In the surgical intervention performed with the open surgery method, the area where the aortic rupture occurs is removed and an artificial vessel (graft) is inserted.
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