An aortic dissection occurs when there is a tear in the inner layer of the aorta. This is the major artery that carries blood from the heart to other areas of the body. Aortic dissection is considered a life-threatening medical emergency. They can happen following a car accident or another incident that results in a traumatic blow to the chest. Patients with Marfan's syndrome are at a higher risk of aortic dissection, as are individuals with high blood pressure. Aortic dissections occur more frequently in patients in their sixties and eighties than in other age groups. This condition occurs twice as much in males as does in females. Patients who perform high-intensity weightlifting and similar strength training exercises have an increased risk of this type of dissection. Doctors perform specialized heart tests, including a computerized tomography scan, a transesophageal echocardiogram, and a magnetic resonance angiogram to diagnose this condition.
Patients need aortic dissection treatment as soon as possible. In some cases, they will receive medication for aortic dissections. A common option is a beta-blocker for aortic dissections. The goal is to gain blood pressure control before surgery. Surgery for an aortic dissection often includes removing the damaged portions and repairing what remains or replacing the valve entirely. Of course, patients must understand the symptoms of an aortic dissection first.
Chest Or Back Pain
An aortic dissection generally causes sudden, severe chest or back pain. Most patients describe the pain as a tearing, shearing, or ripping sensation. It may feel similar to the pain experienced during a heart attack. Beginning under the breastbone, it changes position and can radiate up to the neck or down the patient's back. Many patients with back pain caused by an aortic dissection feel the pain in their upper back at first. Patients experiencing these pains should alert those around them so an ambulance can be called. Paramedics can start life-saving measures on the way to the hospital, and the patient will be seen immediately on arrival.
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Loss Of Consciousness
Depending on the severity of an aortic dissection, patients could experience a temporary loss of consciousness. If this occurs, bystanders should immediately call the emergency services, and someone should stay with the patient until paramedics arrive. While waiting for the emergency teams, individuals at the scene can help the patient by checking their airway to ensure it is not blocked. This is done by gently opening the mouth.
It is important to feel the patient's wrist to check for a pulse. If the pulse is absent, anyone who knows how to do cardiopulmonary resuscitation (CPR) should begin this immediately, and the patient should be placed on their back. The patient's pulse should be checked periodically, and observers should check for signs of breathing, coughing, or movement that could indicate the patient has regained consciousness. If known, bystanders should inform paramedics about the duration of the patient's loss of consciousness.
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Shortness Of Breath
The shortness of breath that occurs with this emergency often appears suddenly and is generally severe. Patients may gasp for air and feel as though they cannot take a full breath. They may breathe very rapidly, and their breaths may tend to be shallow. The severity of the shortness of breath the patient experiences could make it difficult for them to speak.
As part of hospital treatment, patients will be given supplemental oxygen and medications to make it easier to breathe. Some of these treatments can be provided by paramedics on the way to the emergency room. Doctors at the hospital will assess a patient's shortness of breath by observing their breathing pattern, listening to the lungs with a stethoscope, and measuring their respiration rate. Shortness of breath often resolves if the aortic dissection is successfully treated.
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Weakness Or Paralysis
The symptoms of aortic dissection can mimic those of a stroke, and patients could develop weakness or paralysis. As with other symptoms, weakness and paralysis have an abrupt onset with an aortic dissection. In addition, they tend to affect only one side of the body. Patients may notice they have sudden difficulty walking. They could also experience pain or numbness in their toes or fingers. Temporary paralysis of the legs is frequently reported by individuals experiencing this type of dissection. When pulses in the arms and legs are compared, one side of the body will typically have a weaker pulse than the other.
If any weakness or paralysis is present, the patient should lie down as soon as possible to prevent falls or other injuries. Individuals with the patient may want to check for possible signs of a stroke, including drooping on one side of the face. Bystanders may want to write down the patient's symptoms and note the time the weakness or paralysis was first observed. This will help medical staff later. It can be especially beneficial to record which limbs are affected by these symptoms, as this information may help doctors rule out a stroke or other medical conditions.
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An aortic dissection may cause the patient to experience difficulty speaking without warning. The patient's speech may be slurred, and they could be unable to form words. One of the corners of their mouth could droop, and the patient might seem disoriented and confused. Swallowing difficulties have also been reported in patients with an aortic dissection. Speaking difficulties may occur in conjunction with temporary vision loss. Family members or bystanders can ask the patient to repeat a simple sentence and note whether the response is clear or muddled. This should help them evaluate speech difficulties.
Temporary speech difficulties during a medical emergency may make it impossible for the patient to communicate with paramedics and hospital staff. If possible, a family member familiar with the patient's health history should travel to the hospital to be with the patient and provide doctors with crucial information about the patient's conditions and current medications.
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Severe Abdominal Pain
As mentioned, many patients with an aortic dissection often experience chest or back pain. In addition, however, some individuals will also deal with severe abdominal pain. This pain often develops when patients are experiencing an abdominal aortic dissection. Similar to chest or back pain, abdominal pain due to an aortic dissection appears quite suddenly. Abdominal pain due to an aortic dissection is also quite likely to radiate to other parts of the patient’s body. In most cases, this is the back. However, patients may deal with flank pain as well.
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Many of the symptoms associated with an aortic dissection are similar to those seen with a stroke. Previously discussed examples are paralysis or weakness on one side of the body and difficulty speaking. These symptoms often appear alongside vision loss. However, similar to paralysis and weakness, patients with vision loss due to an aortic dissection often deal with the loss on one side of their body. Typically, the vision loss will occur on the same side as the weakness and paralysis. Some patients will first deal with vision problems, such as blurry vision, before vision loss.
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As mentioned previously, many individuals will experience difficulty speaking when they are dealing with an aortic dissection. These patients will often also deal with a certain amount of confusion. They may not fully understand what is happening, which can make it quite challenging for them to communicate with paramedics or other medical professionals. Thus, family members, other loved ones, or bystanders may want to help communicate initial information about the patient’s symptoms to the paramedics. Confusion, along with the other stroke symptoms, is a significant reason why aortic dissection is quite concerning and considered a medical emergency.
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Individuals experience symptoms of aortic dissection in large part because there will be a decrease in the amount of blood that flows throughout their body. The blood flow problem is the major reason why many patients will deal with pale skin due to an aortic dissection. Of course, pale skin alone is not enough to diagnose this condition. Patients need to have at least a few of the other symptoms, such as sudden and severe chest or back pain as well as shortness of breath or difficulty speaking. Otherwise, pale skin is typically a sign of another condition.
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Many patients experiencing an aortic dissection will deal with significant sweating. Most of these individuals will see the sweating present itself as clammy skin. This is what differentiates sweating due to an aortic dissection from sweating due to physical exertion or heat. Patients may be sweating quite heavily, but they will often feel cold at the same time. Heavy sweating due to an aortic dissection often appears alongside pale skin, which was just discussed. Thus, patients may want to watch for pale skin and clammy hands. Of course, when an aortic dissection is the cause, other symptoms will appear as well. Chest and back pain are the most common.