An aortic dissection is a very serious medical condition that needs immediate diagnosis and treatment. There are two types. Type A is the much more serious of the two. The symptoms seem similar to heart attack symptoms. However, Type A aortic dissection requires a rush to the emergency room and immediate surgery. Type B aortic dissection on the other hand may be resolved with medication.
The symptoms of a Type A aortic dissection are pressure in the chest with radiation to the arm, neck or jaw as well as sweating or shortness of breath.
An aortic dissection is described as a tearing sensation in the chest or in the epigastric area that radiates to the back.
Those mostly likely to suffer an aortic dissection are males who have hypertension, a preexisting aortic aneurysm, a history of a bicuspid aortic valve, aortic surgery, and inflammatory disease causing vasculitis and trauma to the chest area by a car crash, work injury or sporting event injury. Women with a condition of hypertension are ones to be on alert for an aortic dissection.
If a patient with hypertension along with chest pain radiating to the back presents at a hospital emergency department, the medical providers, nurses, physicians and attending should suspect an aortic dissection which is a tear of the inner lining (tunica intima) of the aorta, with dissection of blood through its middle layer (tunica media). The aorta leads from the artery of the upper chamber of the heart and runs all the way down through the abdominal area. When an elderly man presents with a pulsatile abdominal mass, one should suspect a rupturing abdominal aortic aneurysm. An aneurysm is a bulging or a balloon-like dilation of a vessel wall of an artery. Should that vessel of the aorta rupture, then the patient should immediately receive emergent treatment.
Although an x-ray can show blood in places where it should not be, the gold standard for diagnosing an aortic dissection is a CT scan.
If the dissection occurs from the ascending aorta and extends to the descending aorta, the most likely diagnosis would be a Type A dissection. Although the Type B dissection is treated with medication, the treatment is lengthy and the patient still remains at risk. The medication only prevents the dissection from becoming worse. Time will allow the damaged aortic wall to heal. The healing process may not always be successful. Should the initial tear worsen, surgery would be immediate and lifesaving.
The patient with chronic high blood pressure stresses the arteries of the body. This stress may cause the rupture or dissection of the aorta. In any case, the occasion of an aortic dissection is an unusual and uncommon occurrence. The condition occurs mostly in men in their 60s and 70s.
In a Type A aortic dissection, the treatment is surgery. In surgery, the area of the aorta with the tear is usually resected and replaced with a graft. In some cases, the onset of an aortic dissection can be predicted by x-ray, but better yet by CT scan. An impending rupture would require emergency surgical correction.
In cases where a patient has a cardiovascular accident, severe left ventricle dysfunction, pregnancy, a previous heart attack six months ago, advanced age or severe valve disease, surgery would not be an option.
Medical management is the treatment of choice for descending aortic dissections unless they are leaking or ruptured. In descending dissections, stenting is an option. Medicine is also administered to surgical patients preoperatively, intraoperatively and postoperatively to prevent progression or a reoccurrence of an aortic dissection.
Although the symptoms of an aortic dissection mimic other also serious conditions, the failure to diagnose and treat emergently is extremely dangerous and life-threatening. As is always the preferred course of action, doctors and medical providers should rule out the deadliest or the most dangerous condition or illness in making their differential diagnoses.
If you or someone you love has suffered from an aortic dissection misdiagnosis and error, please call us for an immediate free consultation. With more than 40 years of experience in trying and settling aortic dissection malpractice cases, Chicago's Kreisman Law Offices provides the best possible services to our many clients and achieves unsurpassed results. Please call us 24 hours a day at 312.346.0045 or toll free 800.583.8002 for a free and immediate consultation, or complete a contact form online.