Aortic Dissection

A very close friend of mine was complaining of sudden onset tooth pain then quickly changed to excruciating chest pain. His family rushed him to the nearest emergency room, where he had an EKG (which came back normal), so a chest CT scan performed with contrast to rule out an aneurysm. The end result was actually a dissection of the ascending aorta. ER staff immediately sent for a helicopter to take him to a very well known hospital in Indianapolis. At the hospital, the doctors were able to fix his dissection through surgery by placing a nylon patch over the dissection. He was in intensive care for 4-5 days, but was over medicated with coumadin, so they had to keep him an extra few days to make sure he was fine. It is amazing to me that he is still living today and that he walked out with only one medication that he takes, which is toprol.

The aorta is the largest artery in the body and arises from the heart and it is made of several layers. A dissection is caused from a tear of the layers in the wall of the aorta. Anyone can have a tear in the wall of the aorta, but it is definately more common in men between the ages of 60-70. It can also occur in post traumatic situations. High blood pressure, hyperlipidemia, weakening of arterial walls, etc are all examples of risk factors for having a dissection.

There are two types of aortic dissection. The first, type A, is where the tear is on the ascending aorta, the second, type B, is where the tear is on the descending side of the aorta. Type A is difinately more crucial because there is a lot more blood flow and pressure at this point.

Surgery can be done to correct the dissection by placing a wire mesh material through the aorta. Medication can also be given to the patient to help a chronic dissection.

References:

Mayoclinic.com
Dr. Mary C Mancini, MD, PhD at webMD.com
www.imagingpathways.health.wa.gov

Emphysema

Emphysema is a chronic obstructive pulmonary disease that is progressive and irreversible. When a patient develops emphysema, the air literally becomes trapped within the lungs because the alveoli (where CO2 is exchanged for O2) starts to collapse. Patients also develop a "barrel chest", which can be seen on a general PA chest x-ray. This "barrel chest" is formed by the rounding of the costophrenic angles.

Some other symptoms may include very short and rapid breaths, shortness of breath, chest pain/tightness, coughing, and fatigue.

My grandfather was a wonderful man, but he had a bad habit. He smoked for years and years. He eventually developed emphysema and his life was shortened after catching pneumonia for a second time within one year. He was in and out of intensive care that year and for his last 5 years he had to carry an oxygen tank with him every where he went. He told my grandmother to "pull the plug" if he ever had to go back under the ventilator. He definitely did not want to live his life like that, and to be honest, who would?

In April of 2004, I went to visit my grandfather in the hospital. I was actually the last grandchild he spoke with before he went into a coma. He told me he was so proud of my sister and I for going to college, being great, honest people, and for not ever smoking. I wish that I could have done more for him and I really wish I would have spent more time with him before he passed away. He was in a lot of pain there at the end! His kidneys failed after he went into a coma, so my grandmother decided it was best to take him off the ventilator. Smoking is such an awful thing to do to your body. I seriously wish everyone would understand that and quit!

References: www.mayoclinic.com, www.ctsnet.org, www.mevis-research.de