Aortic separation

Aortic separation's disease overview

The aorta is the largest artery of the body, coming from the heart, running an arc in the chest, through the diaphragm and down the abdomen. The aorta divides blood supply branches for organs in the body. The aorta can be divided into sections of the path, including the aorta, the aorta, the aorta, the aorta (including the aorta and the abdominal aorta).

The pathological group of the aorta includes many dangerous and complex diseases. Aortic separation (also known as aortic dissection , split into aortic) is a quite severe disease and is tending to increase. The aortic separation is part of the diseases of the acute aortic syndrome (including the aortic separation, the hematoma in the wall, the ulcerative penetration, the aortic aneurysm progresses rapidly, and the injury or the physician causes it go out). The aortic separation occurs when the endothelial tear, the blood flow through the endothelial tears to remove the aorta layers of the aorta, create a false and true heart, spread the spread along the path of the artery , can spread to the abdomen, spread into the organs, chi chi causes many dangerous complications.

Aortic separation is considered to be less than 2 weeks, selling at 2-8 weeks, chronic when> 8 weeks

Aortic separation is classified by De-Bakey or Stanford. In which classification by Stanford is widely used in clinical:

  • Stanford A (type A): There is a split in the aorta (may be accompanied by a split in the strap or aorta)
  • Stanford B (type B): There is no separation in the aorta part

    • Causes of Aortic separation's disease

  • May be due to degeneration: The aorta wall weakened time

    • Conjunctional diseases: Marfan syndrome, Ehlers-danlos syndrome, Leays-dietz syndrome ..

  • may be caused by twisted injuries (car accident), or by a physician (due to tools such as tools used in heart catheter)

    • Symptoms of Aortic separation's disease

    Chest/back pain: This is the most common symptom. Chest pain is often intense, like a knife or as tearing, piercing back, lasting for hours. Sometimes it is necessary to use pain relievers to ease the pain

    Symptoms when spreading widespread:

  • Differences of two -hand blood pressure: can be touched on one hand (usually left hand) weaker than the right hand, sometimes losing vessels. Two -hand blood pressure is over 20mmHg. This is due to the splitting of the aorta spread into the lower artery.
  • Signs of localities: Reducing sudden consciousness, hemiplegia often due to splitting spread into the artery artery causing acute brain stroke

    • Blowing in the heart: Often due to Stanford A Lan aortic aortic separation into the aortic valve, causing aortic valve to create a new diastolic blow, often accompanied by accompanied Symptoms of acute heart failure

    Myocardial infarction: rarely occurs, due to splitting spread into coronary arteries

    Abdominal pain, abdominal distention: Snakehead spreads into the aorta of the aorta and the mesenteric vessels, causing intestinal anemia, reducing intestinal motility, causing pain and abdominal distention

  • Symptoms of broken aortic separation:
  • Shocking, hypotension
  • Difficulty breathing caused by spillway, pleural spill
  • Symptoms of acute heart compression: fuzzy heart sound, decline of pressure, neck veins

    • People at risk for Aortic separation's disease

    In addition to the above reasons, there are risk factors for aortic separation:

  • Elderly

    • Men

  • Smoking
  • Uns control blood pressure
  • Vascular disease: Takayasu vasculitis, giant cell vasculitis
  • Aortic pathology and available aortic valve: aortic waist stenosis, two -leaf aortic valve
  • Use cocaine, amphaamine intravenously
  • Families with aortic disease

    • Prevention of Aortic separation's disease

    Quit smoking and control blood pressure by:

  • Change lifestyle: Exercise regularly, at least 30 minutes a day, 5 days per week
  • Diet reduces salt, lots of green vegetables, low animal fat, replaced with vegetable oils

    • Take medication regularly

    Diagnostic measures for Aortic separation's disease

  • Multi -sequential computerized tomography with aortic -shaped artery: is the most accurate diagnostic method. Based on the film that can identify the disease as type A or type B, the location of the endothelial tear, the spread of the split, the anemia of the organs and the complications of the pericardium, pleura.

    • Determination of an echocardiography: It is possible to be determined when the aorta separates the aorta or the nearby section of the aorta. Especially useful to determine the condition of the heart valve, heart function, pericardium

  • chest X-ray: usually give less information. It can be seen that the images are broad ventricular, pleural fluid when complicated

    • Aortic separation's disease treatments

    Includes three main options: medical treatment, intravascular intervention, aortic replacement surgery.Emergency medical treatment:

  • Pain relievers: Morphin painkillers can be used, derivative of morphine (fentanyl)

    • Control blood pressure: Blood pressure goals need to be controlled below 120mmHg, can use intravenous pills: nicardipine, nitroprusside

    Control circuit: Heart frequency target is about 60-70 cycles/minute, often using oral beta blockers (popular in Vietnam) or intravenous line (popular in Foreign) Separation of Stanford aorta A

    appointment of emergency surgery to replace the aortic segment, can replace the aortic valve depending on the case

    Stanford aortic separation

    If there is complication (pleural effusion, organs anemia) or when prolonged hypertension is difficult to control, prolonged pain, recurrent pain, rapid enlargement, need to intervene, need intervention Inner circuit placed stent graft covering. If there is no complications that can be preserved and closely monitored, but currently indicating stent grafts for this group of objects still bring many benefits (IIA level according to ESC).

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