What is Aortic dissection?
Author: 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.
They accomplish this through:
- Increased access to education for medical professionals and patients in the UK & Ireland
- Working with those responsible for Healthcare policy in the UK & Ireland to ensure that there is consistency in the provision of diagnosis for acute aortic dissection, specialised follow-up for survivors and access to clinical genetics for relatives
- Promoting funding for medical research into the detection, prevention, treatment and cure of aortic dissection
About Aortic Dissection
Aortic dissection occurs when there is a partial tear in the aortic wall. This tear then spreads along the length of the aorta. This can rupture or interrupt the blood supply to limbs or vital organs. If the tear occurs in the first part of the aorta, in the front of the chest, it is called a type A dissection. If it occurs in the aorta in the back of the chest it is a type B dissection. Aortic dissection can affect adults of any age. It is an important cause of maternal death. Untreated type A dissection is almost always fatal. Type B dissection is much less dangerous and is rarely fatal in the short term. In the UK & Ireland, over 2,000 people per year lose their lives from aortic dissection. Whilst death in pregnancy is very rare 11% of maternal deaths from cardiovascular causes are due to aortic dissection. Patients who survive an aortic dissection have a long-term condition that places them at risk of future complications. To minimise the risk of these complications developing and treat them effectively if they occur, patients need to be monitored by specialist medical teams.
Diagnosis of Aortic Dissection
These people do not die because the NHS lacks the facilities to treat them. The problem is that people are not diagnosed quickly enough, if at all. Patients with aortic dissection typically suffer sudden severe chest pain. The pain can settle completely and routine tests carried out in the Emergency Department can be normal. To make the diagnosis it is necessary to carry out an emergency CT scan. Too often a diagnosis of aortic dissection is not considered and a CT scan is not ordered.
Causes of Aortic Dissection
Many conditions predispose a person to aortic dissection and some of these are inherited. If those relatives at risk are identified, measures can be taken to reduce their risk of developing aortic dissection. Screening relatives for these conditions requires specialised clinical genetics input.
Treatment for Aortic Dissection
Treatment for type A dissection requires emergency open-heart surgery. This will save the lives of over three-quarters of patient. Around 3000 patients per year suffer a type A dissection in the UK & Ireland. Half of these die almost immediately after the onset. Although the number of operations for type A dissection is increasing, still only two-thirds of patients who could be saved undergo an operation. The remainder reach hospital but are not diagnosed.
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