Overview
Causes
Symptoms
Diagnosis
Treatment
Our Thoracic Aneurysm/Dissection Specialists
Overview
Aortic dissection occurs when the innermost layer of the aorta tears, allowing blood to leak through and separate (dissect) the inner and middle layers of the blood vessel. Aortic dissection can trigger several different potentially life-threatening events, such as stroke, sudden heart failure, and failure of one or more vital organs. If left untreated, aortic dissection can eventually lead to a fatal rupture of the aorta.
Aortic dissection is a serious, potentially fatal condition and requires the immediate attention of a skilled and experienced team. The NYU Division of Cardiac Surgery has treated hundreds of patients with aortic dissection from the tri-state area in recent years.
Causes
The principal causes of aortic dissection are hypertension and atherosclerosis. Other causes include smoking, hyperlipidemia, hereditary connective tissue disorders such as Marfan's syndrome and Ehlers-Danlos syndrome, and syphilis.
Symptoms
Virtually all people with aortic dissection experience a sudden, ripping pain in the chest and/or back. Other common symptoms include stroke, fainting, shortness of breath, and sudden weakness. Contact your physician immediately if you experience any of these symptoms.
Diagnosis
Most cases of aortic dissection are obvious upon physical exam. Pulses in the arms and legs are diminished or absent in roughly two-thirds of patients with the condition. A murmur (abnormal heart sound), which can be heard through a stethoscope, may also appear. One or more tests are then used to confirm the diagnosis. These include:
- X-ray of the chest
- CT scan of the chest
- Aortography: x-ray procedure performed after injection of a contrast dye that outlines the aneurysm.
- Magnetic Resonance Imaging (MRI): a scanning technology that employs noninvasive magnetic fields and radio waves (instead of x-rays) to obtain two- and three-dimensional images of the body.
- Standard or transesophageal echocardiography (TEE): tests that uses high-frequency sound waves to visualize the heart.
Treatment
Aortic dissection usually requires immediate treatment. Patients diagnosed with this condition are admitted to the intensive care unit, where their vital signs can be closely monitored. Various drugs may be administered, such as sodium nitroprusside, which lowers blood pressure, and a beta blocker, which slows the heart rate.
Whether further treatment is recommended depends on the location of the dissection, the presence of bleeding from the dissection, and the patient’s overall condition. Some patients are treated with medication only. However, immediate surgery may be necessary. To repair an aortic dissection, the surgeon removes the area of dissected aorta and rebuilds the blood vessel with a synthetic graft. The operation typically lasts from three to six hours and requires a hospital stay of a week to ten days.
Our Thoracic Aneurysm/Dissection Specialists
Stephen B. Colvin, MD
Gregory A. Crooke, MD
Alfred T. Culliford, MD
Aubrey C. Galloway, MD
Juan B. Grau, MD
Eugene A. Grossi, MD
Greg H. Ribakove, MD.
Charles F. Schwartz, MD