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
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