Abdominal aortic dissection is a tear in the inner lining of the aorta, the largest artery in the body. The aorta starts in the heart ascending upward before arching and bending down through the chest into the abdomen. The tear will allow blood to flow between the inner lining of the artery and the outer wall, which causes a weakening in the wall of the artery. The weakening will create a balloon-like expansion called an aneurysm, which can rupture and be fatal.
Causes
According to the "American Journal of Nursing," aortic dissection is relatively uncommon. Estimates of its incidence may vary because the condition is often misdiagnosed. Patients with atherosclerosis, a build up of plague on the arteries, high blood pressure and high cholesterol are at a greater risk of developing an abdominal aortic dissection. Smoking and certain inherited disorders, such as Marfan syndrome, are also risk factors associated with dissection.
Signs / Symptoms
The symptoms of aortic dissection, according to "Circulation," may vary. Patients may complain of a sudden onset of severe pain in the back, chest or abdomen. Other patients may complain of shortness of breath, weakness and pain in arms or legs. Because dissections can affect the arteries that supply the heart, patients may experience symptoms similar to a heart attack.
Treatmentt
Treatment for a dissection is to control the tear and prevent further complications. The patient may be put on blood pressure medications to control high blood pressure. High blood pressure causes an increased force to be placed on the arterial wall. With a abdominal aortic dissection, the wall of the artery is already weakened, so preventing high blood pressure will assist in preventing a rupture.
Surgical treatment may also be considered. Surgical treatment may include a graft or a stent being placed in the area of the dissection.
Complications
In the September 2008 issue of "Circulation," Juang et al indicate a primary complication with dissection is the concern that other arteries can be affected as the dissection spreads. If the arteries that supply blood to the heart are involved, the patient may require repair of those arteries by a coronary artery bypass. Following the dissection a patient will require intensive care admission for continuous monitoring. The recovery time after a dissection is usually about 7 to 10 days.
Life Style Changes
According to "Circulation" patients who have had a dissection remain at risk for complications during the first two years after the initial dissection and will require close monitoring. Patients will be monitored with frequent computerized tomography (CT) scans usually at three months post dissection and then every six months for the remaining two years. Patients may also be required to continue blood pressure medications and to avoid strenuous physical activities that could increase blood pressure which in turn would increase stress on the aortic wall. Normal daily activities such as driving, cooking and climbing stairs are not restricted.
References
- "Circulation"; Aortic Dissection; Juang et al; September 2008
- "American Journal of Nursing"; Aortic Dissection: Linda Scheetz; April 2006
