The first case of AD was described in the examination of King George II of Great Britain following his death in 1760. Without treatment, about half of people with Stanford type A dissections die within three days and about 10% of people with Stanford type B dissections die within one month. The typical age at diagnosis is 63, with about 10% of cases occurring before the age of 40. ĪD is relatively rare, occurring at an estimated rate of three per 100,000 people per year. Dissections that involve the second part of the aorta can typically be treated with medications that lower blood pressure and heart rate, unless there are complications which then require surgical correction. Surgery may be done either by an opening in the chest or from inside the blood vessel. Dissections that involve the first part of the aorta (adjacent to the heart) usually require surgery. Management of AD depends on the part of the aorta involved. Prevention is by blood pressure control and smoking cessation. The two main types are Stanford type A, which involves the first part of the aorta, and type B, which does not. The diagnosis is suspected based on symptoms with medical imaging, such as computed tomography, magnetic resonance imaging, or ultrasound used to confirm and further evaluate the dissection. Major trauma, smoking, cocaine use, pregnancy, a thoracic aortic aneurysm, inflammation of arteries, and abnormal lipid levels are also associated with an increased risk. ĪD is more common in those with a history of high blood pressure a number of connective tissue diseases that affect blood vessel wall strength including Marfan syndrome and Ehlers Danlos syndrome a bicuspid aortic valve and previous heart surgery. Aortic dissection can quickly lead to death from insufficient blood flow to the heart or complete rupture of the aorta. Other symptoms may result from decreased blood supply to other organs, such as stroke, lower extremity ischemia, or mesenteric ischemia. Also, vomiting, sweating, and lightheadedness may occur. In most cases, this is associated with a sudden onset of severe chest or back pain, often described as "tearing" in character. Aortic dissection ( AD) occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart.
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