Aortic dissection: symptoms

The aorta is the largest blood vessel of the human body. Like any vessel, it is susceptible to various diseases, but its large size and the maximum length (there is a chest and abdominal the it departments) of all arterial vessels lose makes it special. So, almost never infarction of the aorta, or its complete blockage by a blood clot. Simply no blood clots, to stop the blood flow in that vessel. But there are aortic lesion like aneurysm and dissection (dissection). The symptoms of these lesions will be discussed.

In Latin the word «dissectio» means «dissection, dissection». It is this synonym, you can select the term «aortic dissection». Sometimes you can find the term «dissecting aneurysm». What is it, and how does this disease? Instead of «get» definitions from the textbooks of surgery, let us come to him on their own. It is known that the aorta is the largest vessel, similar to a main pipe with a diameter of 1 meter, extending from the CHP. And as in any main vessel, designed for heavy load, there is a thick aortic wall.

But unlike pipe vessels are a multilayer structure. Distinguish at least three concentric shells within each major vessel. If in the pipe there is a defect, the water just breaks the wall and rushes out. In the aorta the blood, finding the defect of the inner shell, flows between the layers of the vessel and rushes forward. Thus there is a gradual aortic dissection, with deeper streaks of blood between its layers. This process is like trying to separate the stuck together edges of a plastic bag with the help of a blast inside.

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The result is aneurysmal expansion of the vessel, or simply aortic aneurysm. If violated all three walls, there is a rupture of the aorta, and the patient’s death from massive blood loss is absolutely inevitable, even if it happens in the hospital. Moreover, death is very likely even if it happens suddenly, during surgery in the cardiac unit. Under the strong «pressure» there is no way to connect the vessel edge, and clamp the aorta impossible. You can survive only when the scheduled operation, that is, the diagnosis in advance. And to make a diagnosis, you need to pay attention to the symptoms that are characteristic of aortic dissection.

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Signs of aortic dissection

First of all, you need to understand that the emergence of «pockets» with streaks in it, a large amount of blood means the withdrawal of this amount from the riverbed. Therefore, there are both local and distant symptoms. Depending on what happened dissection of the chest (which happens often) or the abdominal Department, and which layer is damaged, you receive the following symptoms:

  • Tear the inner lining of the aorta (intima). Is the primary lesion of the aorta. It begins with the formation of the aneurysm. If the vascular wall is thick, this primary affect leads to acute pain in the chest or abdomen. Localization of pain in the center of the body, as the aorta is retroperitoneal. The pain depends on the change of body position and blood pressure levels. The second symptom of this stage is a painful shock and vascular collapse.
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Of course, the emergency physician is unable to establish the diagnosis. It is important to rule out a cardiac event, after which the patient can be transferred to the Department of urgent surgery to avoid acute pancreatitis and other diseases (in the case of lesions of the abdominal aorta), or coronary care unit (pain in breast).

  • The continued flow of blood between the severed layers generate a second, more severe attacks of pain. Since the blood penetrates far, the pain becomes slightly weaker (by reducing pressure), but may carry a pulsating nature with the strengthening of systole, and to be poorly localized, because this process covers a much larger area than before.

In this period, the dissection of the aorta reaches such an extent that affects the blood flow in those organs which krovosnabjaemah vessels lying near the area of dissection. So, when an aneurysm of the abdominal aorta may be infarction of the kidney due to sharp shortage of blood in the renal arteries. With the defeat of the mesenteric vessels may occur with infarction of the intestine with the development of resciesa pain, necrosis of the intestinal loops and the subsequent peritonitis. It is also possible to ischemia of the stomach, liver, infarction of the spleen.

At dissection of the thoracic aorta are often captured area of origin of the coronary vessels. So maybe the advent of extensive infarcts or severe episodes of ischemia. Prehospital emergency physician is almost impossible to understand what an attack of acute ischemia and chest pain hides two of the disease, as all his thoughts and actions are aimed at rapid relief of ischemia and infarction hospitalization in the ward. With the defeat of the aortic arch may lead to the termination of blood flow in the left common carotid artery, severe ischemic strokes.

  • Finally, when a complete break occurs profuse retroperitoneal bleeding with tamponade of the retroperitoneal hemorrhagic shock and death.
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In conclusion, I must say that «the trouble does not come alone.» This means that if ever there is a very strong pain in the chest or abdomen, and «found nothing», if you are of elderly age, there are signs of atherosclerosis or vascular problems to know about the state of his main blood vessel and to take appropriate action by making a MRI of the thoracic or abdominal cavity.

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