Aortic Aneurysm and Dissection

Mar 31, 2012 , Translated by Kristina Knazko

aneurysma-a-disekce-aorty2.jpg - kopie
aneurysma-a-disekce-aorty2.jpg - kopie
An aneurysm is the bulging of a vascular wall. It can develop on any artery but the most severe and life-threatening cases are aortic aneurysms. Dissection means tearing of the vascular wall. During dissection, individual layers of the vascular wall separate and blood flows through in two streams.

Aortic Aneurysm and Dissection

The aorta is the largest artery in the human body. It begins at the left ventricle and ends in the abdominal cavity. Here it divides into two major branches supplying the lower limbs. It is the main artery from which arteries supplying vital organs such as the brain, heart and kidneys, branch off. From the left ventricle, the aorta is known as the ascending aorta, continuing as the aortic arch, followed by the descending aorta. Furthermore, its parts are named according to where it is passing through. The thoracic and abdominal aortas are distinguished. Aneurysms form mainly in the abdominal aorta, whereas aortic dissection occurs in the thoracic aorta, more specifically the ascending aorta.

Aortic Aneurysm

An aneurysm is a bulging of the vascular wall. A hallow pocket is created where blood flows. Aneurysms form in weakened areas of vascular walls. Vascular inflammation can be the causes, as it weakens the walls, as well as atherosclerosis and high blood pressure.

Symptoms and Consequences of an Aneurysm

The problem with aneurysms is that until the aneurysm bursts, the condition is typically asymptomatic. Large aneurysms can be palpated in the form of a pulsing area during abdominal examinations. It can put pressure on surrounding organs and cause back or abdominal pain. The presence of aneurysms should always be monitored. In the event that the aneurysm reaches a certain size, typically 5 cm (2 inches), surgery is required. In the thoracic aorta, aneurysms are rare, they usually form in the abdominal area. The danger is that the aneurysm may burst and blood will spill into the surrounding area. Given the size of the aorta and the amount of blood that flows through it, as well as the size of the abdominal cavity, there is a risk of extensive internal bleeding and circulatory collapse. The patient then experiences a very serious condition: shock.

Diagnosing an Aortic Aneurysm

An aortic aneurysm is not easy to diagnose as its size can vary and it usually does not cause any symptoms. In the case of a larger aneurysm, a pulsating area in the middle of the abdomen can be palpated during a physical examination. This finding can be confirmed via a stethoscope, where whirling sounds can be heard. A reliable method for confirming a diagnosis is the use of a CT or ultrasound of the abdomen. A CT or CAT scan is a test that uses x-rays to create a 3D image. Its disadvantage is that it emits a high dose of radiation that the body subsequently absorbs. The ultrasound is a completely safe method as it uses sound penetration and its various levels of absorption in different tissues.

Treating an Aortic Aneurysm

Treatment of aortic aneurysms is based on remediating factors that took part in the development of this disease. Medications from various groups are administered. High blood pressure needs to be lowered, as well as cholesterol levels in the blood. The only way to fix the aneurysm is with surgery. Often the first approach is the insertion of a stent, a metal reinforcement, into the aorta to support its walls. Other methods to support the aortic walls in the bulging area exist, but these are complicated and performed solely by a specialist in vascular surgery.

Aortic Dissection

Aortic dissection is a tear in the vascular wall. Arterial walls consist of 3 layers. If the first, internal, layer is damaged, blood enters between the second and third layer, causing dissection. Unlike an aneurysm, aortic dissections usually form in the thoracic aorta. The causes include high blood pressure, diseases of the vascular tissue, and rarely, atherosclerosis.

Symptoms and Consequences of Aortic Dissection

Aortic dissection is a tear in the wall of the ascending aorta. Blood accumulates in the tear and forms a pocket similar to an aneurysm. This pocket can restrict blood flow in the blood vessels, even blocking it completely. The tear can progress further and affect connecting arteries. These can also narrow or close up completely. Aortic dissection is manifested by sudden severe pain behind the sternum, though this condition can spontaneously disappear. Due to the fact the aortic aneurysms commonly occur in the ascending aorta where coronary arteries connect, it can cause a heart attack or affect the aortic valves. Cerebral arteries can also be affected, which is manifested by a stroke, or paralyses of certain parts of the body. The kidneys can also be affected, decreasing urine output. Shock will develop in the event of major blood loss.

Diagnosing Aortic Dissection

Diagnosis of aortic dissection lies primarily in a detailed medical history and the exclusion of acute myocardial infarction with the help of an EKG. A chest x-ray can also be performed, as well as an ECHO, i.e. an ultrasound of the heart. The fundamental method that reveals the vast majority of aortic dissection s is the transesophageal echocardiogram. This is an ultrasonic examination of the heart, where a probe is inserted through the mouth into the esophagus and stomach, and allows more precise imaging of the structure of the heart and aorta.

Treating Aortic Dissection

Aortic dissection is always considered a life-threatening condition, however, its progression may not always be dramatic. Temporary and permanent stabilization of the condition is possible. This depends largely on the size of the tear. Dissection in the thoracic area always requires surgery. Abdominal dissections, in good conditions and without risk of complications, do not require surgery.

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September 18, 2016 1:29 AM

Prasad: I'm so glad for all of you about the surgeon's aidcve and encouragement. Dad has had an enlarged aorta for years, and every once in awhile his cardio. dr. says something about surgery, and the surgeon says no way . So we are very familiar with the concern and relief you are feeling! So happy it's not an aneurysm! http://poupym.com [url=http://gfnybng.com]gfnybng[/url] [link=http://yqvzauz.com]yqvzauz[/link]

March 2, 2016 7:11 PM

Rajesh: Mike- thanks for<a href="http://yesysfvuzf.com"> seinttg</a> this blog up. This type of communication does not surprise me- the computer guru. My heart breaks for you and your family. I love ya'll so much. There are many serious things going on with your mom, all of which God has in His control. I am praying for Regina, as I know she is struggling with this. Kiss and hug Pop for me and know that I love you and your family. Please let me know what I can do. I am available any time you need me. Love Elbow- Christi

March 2, 2016 1:57 PM

Aliaan: General practitioners tend to disimss symptoms, in my experience. A good friend was told he had acid reflux and sent home with a purple pill despite very obvious major symptoms that something was truly awry. He was dead of lung cancer within weeks, diagnosed very late stage after a trip to the ER. I can tell a number of similar stories unfortunately, most of us put off going to the ER because we disimss our own symptoms, don't want the drama , or because of the financial burden.

February 21, 2016 11:27 AM

Mosharof: That is terrible. I would not wish that on annyoe.And I would never go to a GP with that kind of pain.GPs have a difficult finding things with a flashlight, much less figuring out something as direas what your brother had. With pain that severe, theonly place to go is a good ER , and hoping the rightkind of doctors are on duty.Yes, we all try to play down pain, and often are told by loved ones, that it is just a pulled muscle,or a headache,take an asprin. Famous Last Words.One word : ER http://zaioaq.com [url=http://lgdnwuovmw.com]lgdnwuovmw[/url] [link=http://uclwpgudn.com]uclwpgudn[/link]

July 19, 2015 12:02 PM

Jamshid: I'm very sorry to learn of your brother's<a href="http://chelyhyldy.com"> uilemnty</a> and preventable death. On February 15, 2006 I awoke feeling fine. Yet, within a few hours I was undergoing open heart surgery at West Houston Medical Center to repair a dissecting aorta. My symptoms were a sudden, intense chest pain. After briefly passing out I called 911 and was soon at the hospital ER. Fortunately, doctors there soon diagnosed my condition and that afternoon a surgeon was able to insert a dacron tube in my aorta, saving my life. And, my brother's life: he was advised to have a CT-scan after my experience and was found to have an aortic dissection (and no symptoms). Surgery the next day to correct the condition saved his life.We were both extremely fortunate.

July 17, 2015 2:45 AM

Bhargav: Our experience has had an icmpat of my view oftreatment in our society at the ER.My husband was experiencing severe headaches for 2 days and drove to the local ER. They prescribed antihistamine medication and within the next two days he developed severe back and abdominal pain. My son called the emergency medics and rushed him to the local hospital..Within one hour he was prepped for surgery andupon being prepped he died outside the surgical unit. My son was devastated, I found him outside the room in the doctors arms. I never knew the implications of this condition and only learnedthat my husband had an aneurysm after he passed.My faith in hospitals is now gone and I tell all that always seek another opinion. Life is never going to be the same and our world changed completely on July 25, 2005. Jeanette http://bvepoyysnmp.com [url=http://flxrgoenuk.com]flxrgoenuk[/url] [link=http://mjzmyz.com]mjzmyz[/link]

July 14, 2015 2:55 AM

Pietro: John, I am very to sorry to hear what you are going through. I<a href="http://vdgaiwv.com"> sugegst</a> that you Google the site Ask a heart doctor. This will take you to a website that is operated by the Texas Heart Institute. You can email them what you posted above, and one of their surgeons will respond within 48 hours with an opinion. THI was listed as 4th in the nation in cardiac care. From what I understand, Dr. Joseph Coselli, who practices there and is a faculty member at Baylor College of Medicine, is one of the best in the world in aortic aneurysms. I will keep you in my prayers as well, and I hope that you will get health insurance soon. At the Baker Institute, we work every day to provide information that will improve the health care system. Stories like yours remind us that our progress is painfully slow.

July 13, 2015 8:17 PM

Bojan: Five years ago I was having chest pain and went to the ER. During a CAT scan they found an anyiseurm in my aeortic arch. It is 4.7 CM and I found out that they don't operate on it until it gets to 5.5 CM., so they had me go home.From there for the first year I had to have a CAT Scan every three months, and then every 6 months, and now once a year. I have gone to a couple of Thoracic surgeons and they told me other then keeping an eye on it there wasnt anything to be concerned about. Then I went to a specialist at Vanderbilt in Nashville, TN. He disagreed with all the other surgeons and told me its not if I will ever have to have it done but when.Finally, for the last 2 days I have been having off and on again shortness of breath, even when resting. I am so sorry for your loss, and at the same time it scared me a little. I am 52 years old, and with no health insurance, so I am in a dilemma. May God bless you and your family.

July 11, 2015 10:45 AM

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