Aortic Dissection
Aortic dissection may occur in any location along the aorta and therefore the range of presentations is broad. Many AD patients do not fit the textbook presentation - Alexandra Ortega MD
image by: Aortic Dissection Awareness UK
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Aortic dissection: Getting to the heart of the matter
Fleming, originally from Kerry, was an active and healthy man with no underlying health issues. So when he died unexpectedly in 2015, aged 69, his family was distraught.
Married to Kathleen, the father-of-four (Caroline, Aisling, Catherine and Jeremiah), was attending a business meeting in Dublin when he suddenly became unwell with, according to his daughter Catherine, “excruciating pain in his back, chest and abdomen”. He collapsed and was taken immediately taken to A&E, but, despite medical intervention, he died.
“When Dad was triaged, a 10 out of 10 pain score was recorded and one of the doctors made a diagnosis of aortic dissection and ordered an urgent CT scan and…
Resources
On a Tear: Aortic Dissection
This is the truest form of hypertensive emergency. RAPID lowering is needed as fast as possible in order to prevent false lumen expansion. Target: “as low as possible”, but realistically 100-120 systolic in <30 minutes, HR <60. Agent of choice: Esmolol > Labetalol > Diltiazem > Nicardipine/Clevidipine > Nitroprusside. *Clevidipine is faster onset and usually cheaper than nicardipine. Esmolol dosing: 500 mcg/kg loading dose in 1 minute. Infuse at 25-50 mcg/kg/minute; maximum of 300 mcg/kg/minute.
Silent killer: Everything you need to know about aortic dissection
It isn’t exactly news that multiple diseases can inhabit our bodies without notice. Unfortunately, we’re doing ourselves a disservice if we only acknowledge ailments such as cancer or high blood pressure as “silent killers.” Aortic dissection, which begins as a tear in the aortic wall, also deserves a spot on that list. The often-fatal condition is blamed for more than 13,000 deaths a year in the U.S.
My Aortic Dissection: Acute 'Type A' Aortic Dissection
I will NOT apologise for this long winded ramble - but it's apparently a known (and most remarkable) feature of having an aortic dissection (or just maybe ANY devastating life-critical emergency) that you remember EVERY single detail in excrutiating minutiae. So here you go..!
Acute Cardiovascular Emergency: Missed Killer in the Emergency Room
Acute Aortic syndromes constitute uncommon but lethal identities, with high morbidity and mortality requiring a high index of suspicion, appropriate diagnostic tools and urgent line of management.
Denying Death No More
Discovering that your largest artery contains a bulge that any moment could burst and kill you changes the way you think about yourself. News of my aneurysm slayed the self-perception I'd had -- that of a superhealthy 43-year-old triathlete. Suddenly, I was a Code Blue just waiting to happen. A view of one's self as unhealthy can become self-fulfilling, many doctors say.
Do you know the symptoms of an aortic aneurysm? I wish my brother had
From prior experience, Michael’s friend knew that chest pain radiating to the back is a common sign of aortic dissection. Yet the physician missed this. He took an X-ray of Michael’s chest and explained that he couldn’t see anything wrong.
Heavy Weight Lifting Is Dangerous for Some
Dissections -- an often-fatal tearing of the aorta's inner lining, as in the recent death of actor John Ritter -- predominantly occur where the aorta has ballooned out into an aneurysm. The dissection is commonly deadly because the torn lining often can block other arteries that feed vital organs. In other instances, the dissection is fatal because blood flows back into the sac around the heart, causing a condition called cardiac tamponade; in it, blood surrounding the heart constricts it so that it can't beat adequately.
How a Torn Aorta Can Do Lethal Damage
Tears are often but not always associated with aneurysms, which are bulging, weakened areas in the artery wall. High blood pressure may contribute to both problems.
Learning to Defuse the Aorta
When Dr. Hal Dietz arrived at Johns Hopkins University in the 1980s, he became obsessed with helping children with Marfan syndrome, a rare and often fatal disorder that can cause the aorta, the large blood vessel that carries blood from the heart, to grow and grow until it bursts. That journey has led to surprising discoveries about Marfan’s causes and a soon-to-be published clinical trial of a drug that may help its sufferers.
The Man on the Table Devised the Surgery
But when his heart kept beating, Dr. DeBakey suspected that he was not having a heart attack. As he sat alone, he decided that a ballooning had probably weakened the aorta, the main artery leading from the heart, and that the inner lining of the artery had torn, known as a dissecting aortic aneurysm.
Aortic dissection: Getting to the heart of the matter
September 19th to 26th is Global Aortic Disease Awareness Week when countries around the globe come together to try and increase awareness of this often-fatal disease.
THINK AORTA
The THINK AORTA campaign aims to raise awareness and improve diagnosis of Aortic Dissection worldwide.
International Registry of Acute Aortic Dissection
The International Registry of Acute Aortic Dissections (IRAD) is a consortium of research centers that are evaluating the current management and outcomes of acute aortic dissection. It was established in 1996, and currently has 30 large referral centers in 11 countries participating in the registry. The main purpose of IRAD is to assess the etiological factors, modes of presentation, clinical features, treatment, and hospital outcomes of patients with acute aortic dissection around the world.
John Ritter Research Program
Welcome to The John Ritter Research Program in Aortic and Vascular Diseases at The University of Texas Health Science Center at Houston (UTHealth). Our mission is clear: We are working to prevent premature deaths due to thoracic aortic disease by improving diagnosis, treatment, and public awareness of this disease.
MayoClinic
Aortic dissection is relatively uncommon. The condition most frequently occurs in men in their 60s and 70s. Symptoms of aortic dissection may mimic those of other diseases, often leading to delays in diagnosis. However, when an aortic dissection is detected early and treated promptly, the chance of survival greatly improves.
MedicineNet
There are two types of dissection: Type A is treated surgically, while type B is treated with medical management.
Patient
The most common sites for the intimal tear are within 2-3 cms of the aortic valve or distal to the left subclavian artery in the descending aorta.
The Aortic Dissection Charitable Trust
The Aortic Dissection Charitable Trust aims to improve the diagnosis of aortic dissection and bring consistency of treatment across the whole patient pathway.
Aortic Dissection Awareness
The national patient association for Aortic Dissection in the UK & Ireland. Supporting patients & families; raising awareness; driving improvements in care and outcomes across the patient pathway and enabling research into this devastating condition.
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