Dissecting aortic aneurysm (tearing and dilation of the aorta)

Description Occurs when the wal...

Description

Occurs when the wall of the aorta becomes torn or divided and blood dissects between the layers of the blood vessel. The aorta is the largest artery in the body and it carries oxygenated blood away from the heart. As the vessel wall is damaged, the openings to other important arteries can become occluded causing strokes, heart attacks or other serious organ damage. The aorta can burst causing the patient to quickly bleed to death. Dissections are usually caused from atherosclerotic disease and high blood pressure or because of congenitally abnormal elastic tissue. The dissection can occur in the aorta in the chest (thoracic), in the abdominal aorta, or in both the chest and the abdomen.

Symptoms

Chest pain that has a tearing quality and radiates to the back, shortness of breath, fainting, weakness, low blood pressure.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. X-rays cannot accurately diagnose the dissection. A chest CT scan or a special MRI (called a magnetic resonance angiogram, or MRA) and an echocardiogram are the best diagnostic studies.

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Electrocardiogram (EKG), Magnetic resonance imaging (MRI), Troponin, X-ray

Other Specific Tests: Transesophageal echocardiogram

Specialists:
Cardiothoracic Surgery, Vascular Surgery

Treatment

If the dissection involves the first part of the aorta in the chest surgery is usually required. If only the latter portion of the aorta is involved, aggressive blood pressure control without surgery may be acceptable. Surgery is also performed if important blood vessels supplying important organs are blocked or if the dissection is expanding or the aorta is enlarging.