Precursors of aortic dissection

Aortic dissection is very serious and will affect our life and health. For patients with aortic dissection, they must go to the hospital for examination and hospitalization in time. Aortic dissection usually requires surgical resection. For relevant patients, do not walk around on your own to avoid sudden disease risks. You can perform some bed movements with the supervision of your family. So, what are the signs of aortic dissection?

1. Precursor of aortic dissection

1.1. Severe chest pain. Before aortic dissection ruptures, patients will experience severe chest pain in the chest and back. The pain will radiate to the neck, jaw, shoulder blade area, left arm or upper abdomen, and last for tens of minutes to several hours. Taking nitroglycerin sublingually will not relieve the pain, and the patient will appear in shock. Symptoms of aortic dissection

2.1. Compression symptoms. Aortic dissection rupture is the result of the false lumen expanding continuously and becoming unbearable for the body's blood vessels, thus producing a series of compression characteristics before rupture. When the dissection compresses the true lumen, it causes acute occlusion of the arteries, which will cause ischemia of tissues and organs, insufficient blood supply to the heart and brain, causing myocardial infarction, intestinal infarction and cerebral stroke, and affect the blood supply to the kidneys, causing hemiplegia or paraplegia of the lower limbs.

2. Causes of aortic dissection

In most patients, the smooth muscle and elastic tissue in the middle layer of the aorta undergo degeneration, sometimes with cystic changes (cystic necrosis in the middle layer). The most common complication of medial degeneration is hypertension, which occurs in >2/3 of cases, and is particularly prevalent with distal dissection tears. Others include inherited connective tissue disorders, particularly Marfan and Ehlers-Danlos syndromes; congenital cardiovascular anomalies such as coarctation of the aorta, patent ductus arteriosus, and bicuspid aortic valve; atherosclerosis; trauma; and granulomatous arteritis. Arterial cannulation and cardiovascular surgery can cause iatrogenic dissection.

3. Diagnosis of aortic dissection

If blood leaks from the aorta, there is often a mild leukocytosis and anemia, and aspiration of blood from the left pleural cavity is an important clue. Serum aspartate aminotransferase (AST) and creatine kinase (CK) concentrations are usually normal. Due to hemolysis of blood in the false lumen, serum lactate dehydrogenase (LDH) concentration may increase. There are no changes on the ECG unless a dissection occurs with a myocardial infarction. ECG and serum enzymes help to differentiate between myocardial infarction and aortic dissection, and correct differentiation is crucial in considering whether thrombolytic therapy is needed for acute myocardial infarction.