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Heart and Main Vessels  
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Definition  

Aortic dissection occurs when the layers of the aorta separate. The aorta is the main artery leading from the heart. Arterial walls have three layers. A tear in an inner layer can admit blood under pressure that works its way between layers, causing the layers to dissect apart or separate. This process can squeeze off the main channel so that blood cannot get through the main aorta or any of its branches.

This is a life-threatening event since it can cause stroke , sudden cardiac arrest , or death to impaired blood flow to a number of vital organs. The enlarging mass of misdirected blood can also compromise nearby structures, such as the airways, lungs, or heart. It may also rupture with catastrophic bleeding.

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Causes  

Elevated blood pressure and a diseased aorta are the principal causes, usually due to atherosclerosis . Other congenital and acquired afflictions of the aorta also increase the chances of dissection.

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Risk Factors  

Factors that may increase your chance of aortic dissection include:

  • Hypertension
  • Atherosclerosis
  • A major chest injury, such as an auto accident
  • A hereditary connective tissue disorder
  • Nearing the end of a pregnancy
  • Untreated syphilis
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Symptoms  

If you experience any of the symptoms below, see your physician. They may reflect aortic dissection or many other serious and not-so-serious conditions. These are the most common, but there are many other possible symptoms since the aorta supplies blood to every organ in the body except the lungs.

  • Sudden, ripping pain in the chest and or back
  • Stroke
  • Fainting
  • Shortness of breath
  • Sudden weakness
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Diagnosis  

The usual case of aortic dissection appears in the emergency department as a sudden catastrophic event. Your emergency physician will ask about your symptoms and medical history. A physical exam will be done. Imaging tests evaluate the aorta and surrounding structures. These may include:

  • Chest x-ray
  • CT scan of chest and abdomen
  • MRI scan of chest and abdomen
  • Echocardiogram
  • Aortography—x-rays taken after dye is injected into the aorta through a surgically placed catheter
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Treatment  

You will most likely be admitted to the intensive care unit (ICU) for stabilization and further