Not to be confused with Abdominal aortic aneurysm or Aortic rupture.
Medical condition
Aortic dissection
Dissection of the descending part of the aorta (3), which starts from the left subclavian artery and extends to the abdominal aorta (4). The ascending aorta (1) and aortic arch (2) shown in the image are not involved in this condition.
Specialty
Vascular surgery, cardiothoracic surgery
Symptoms
severe chest or back pain, vomiting, sweating, lightheadedness[1][2]
High blood pressure, Marfan syndrome, Loeys-Dietz Syndrome, Turner syndrome, bicuspid aortic valve, previous heart surgery, major trauma, smoking[1][2][3]
Diagnostic method
Medical imaging[1]
Prevention
Blood pressure control, not smoking [1]
Treatment
Depends on the type[1]
Prognosis
Mortality without treatment 10% (type B), 50% (type A)[3]
Frequency
3 per 100,000 per year[3]
Aortic dissection explanation video
Aortic dissection (AD) occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart.[3] In most cases, this is associated with a sudden onset of severe chest or back pain, often described as "tearing" in character.[1][2] Vomiting, sweating, and lightheadedness may also occur.[2] Damage to other organs may result from the decreased blood supply, such as stroke, lower extremity ischemia, or mesenteric ischemia.[2] Aortic dissection can quickly lead to death from insufficient blood flow to the heart or complete rupture of the aorta.[2]
AD is more common in those with a history of high blood pressure; a number of connective tissue diseases that affect blood vessel wall strength including Marfan syndrome and Ehlers–Danlos syndrome; a bicuspid aortic valve; and previous heart surgery.[2][3] Major trauma, smoking, cocaine use, pregnancy, a thoracic aortic aneurysm, inflammation of arteries, and abnormal lipid levels are also associated with an increased risk.[1][2] The diagnosis is suspected based on symptoms with medical imaging, such as CT scan, MRI, or ultrasound used to confirm and further evaluate the dissection.[1] The two main types are Stanford type A, which involves the first part of the aorta, and type B, which does not.[1]
Prevention is by blood pressure control and smoking cessation.[1] Management of AD depends on the part of the aorta involved.[1] Dissections that involve the first part of the aorta (adjacent to the heart) usually require surgery.[1][2] Surgery may be done either by an opening in the chest or from inside the blood vessel.[1] Dissections that involve the second part of the aorta can typically be treated with medications that lower blood pressure and heart rate, unless there are complications which then require surgical correction.[1][2]
AD is relatively rare, occurring at an estimated rate of three per 100,000 people per year.[1][3] It is more common in men than women.[1] The typical age at diagnosis is 63, with about 10% of cases occurring before the age of 40.[1][3] Without treatment, about half of people with Stanford type A dissections die within three days and about 10% of people with Stanford type B dissections die within one month.[3] The first case of AD was described in the examination of King George II of Great Britain following his death in 1760.[3] Surgery for AD was introduced in the 1950s by Michael E. DeBakey.[3]
^ abcdefghijklmnopqrNienaber CA, Clough RE (28 February 2015). "Management of acute aortic dissection". The Lancet. 385 (9970): 800–811. doi:10.1016/s0140-6736(14)61005-9. PMID 25662791. S2CID 34347018.
Aorticdissection (AD) occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the...
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fatal due to dissection or "popping" of the aneurysm leading to nearly instant death. Thoracic aneurysms are less common than an abdominal aortic aneurysm...
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Familial aorticdissection or FAD refers to the splitting of the wall of the aorta in either the arch, ascending or descending portions. FAD is thought...
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organs. For example, in an aorticdissection, if the left subclavian artery orifice were distal to the origin of the dissection, then the left subclavian...
degeneration) in the ascending aorta causes an aortic aneurysm or aorticdissection, a surgical emergency. An aorticdissection is most often fatal and presents with...
treat aneurysms of the abdominal and thoracic aorta, aorticdissection, acute aortic syndrome, and aortic ruptures. Aortobifemoral bypass is also used to treat...
artery dissection. People with an aneurysm of the aortic root and people with a history of migraine may be predisposed to vertebral artery dissection. Vascular...
Arterial dissections include: an aorticdissection (aorta), a coronary artery dissection (coronary artery), two types of cervical artery dissection involving...
aneurysm. John Ritter died in 2003 of a misdiagnosed thoracic aorticdissection (aortic aneurysm). Isabel Granada died of a cerebral aneurysm. Geoffrey...
(31%), pulmonary embolism (2%), pneumothorax, pericarditis (4%), aorticdissection (1%) and esophageal rupture. Other common causes include gastroesophageal...
Although aorticdissection can frequently extend into its peripheral territories, it is rare for these branches to have dissection without main aortic trunk...
Ritter Research Program in Aortic and Vascular Diseases with the goal of preventing premature deaths due to aorticdissection by identifying genetic mutations...
~22% of strokes in patients under the age of 45 years. Aorticdissection Vertebral artery dissection Amal Mattu; Deepi Goyal; Barrett, Jeffrey W.; Joshua...
compared to other antibiotics. People at increased risk include those with aortic aneurysm, hypertension, certain genetic conditions such as Marfan syndrome...
Anatomie und Physiologie und für klinische Medizin, 1929, 273: 454-479. GeneReview/NCBI/NIH/UW entry on Thoracic Aortic Aneurysms and AorticDissections...
patients with aorticdissection, noting the extremely complex nature of open surgical repair in these patients. In uncomplicated aorticdissections, no benefit...
tamponade is associated with aorticdissection. In this case, there is a high risk of the procedure worsening this aorticdissection by causing haemorrhage...
Abdominal aortic aneurysm (AAA) is a localized enlargement of the abdominal aorta such that the diameter is greater than 3 cm or more than 50% larger than...
the artery to the eye with resulting blindness, as well as aorticdissection, and aortic aneurysm. GCA is frequently associated with polymyalgia rheumatica...
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failure (12%). Less common presentations include intracranial bleeding, aorticdissection, and pre-eclampsia or eclampsia. Massive, rapid elevations in blood...
imperfecta, aorticdissection, Behçet's disease, reactive arthritis and systemic hypertension. Aortic root dilation is the most common cause of aortic regurgitation...
the aorta. The procedure is known as an aortogram. The diagnosis of aorticdissection can be made by visualization of the intimal flap and flow of contrast...
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