Dissection of the aorta. Signs of aortic aneurysm rupture
Aortic dissection is a dangerous pathology: blood flows between the layers of the aorta walls and separates them. This can lead to internal bleeding and death. Therefore, doctors immediately refer the patient to the hospital if they detect symptoms of dissection of the thoracic aorta or others. Surgical intervention and observation is a mandatory program.
Classification of aortic dissection
Proximal and distal dissection of the aorta are distinguished. In the first case, the stratification occurs in the ascending part of the aorta, in the second - in the descending part. But in diagnostics, the classification of aortic dissection according to Debike types is more often used:
- 1 type – stratification is observed in the ascending part of the aorta and spreads to the thoracic and abdominal parts;
- Type 2 – stratification occurs only in the ascending part of the aorta;
- Type 3 – stratification is observed in the descending aorta, may spread to the distal parts of the abdominal aorta, sometimes – to the arch and ascending part.
During the examination of the patient, the duration of the delamination process must be determined - the one that started no more than 2 weeks ago is considered acute, and the one that lasts more than 15 days is considered chronic.
Symptoms of pathology
If the pathology is acute, severe pain is noted in the area of the heart. It often imitates the pain of a myocardial infarction, because of this, the diagnosis will be wrong, and the treatment will be wrong. Under such circumstances, most patients die.
The clinical picture depends on the department in which the delamination occurs. For example, acute pain in the stomach with radiation to the back, shoulder blade, and neck is characteristic of damage to the abdominal aorta.
The chronic form of the disease is almost asymptomatic. But if there is a period of exacerbation, signs of rupture of a stratified aortic aneurysm appear.
Diagnostic measures
Symptoms are not enough to make an accurate diagnosis, they often mimic the symptoms of other diseases. The doctor will prescribe a comprehensive examination, which includes:
- ultrasound examination – allows you to study all parts of the vessel, it is possible to detect stratification of the aortic arch on ultrasound;
- X-ray of the chest is necessary for the differential diagnosis of aortic dissection with other pathologies of the chest organs (for example, tuberculosis);
- ECG in case of dissection of the thoracic aorta - allows to rule out myocardial infarction;
- aortography – X-ray examination of the aorta filled with contrast material.
The most informative is the diagnosis of aortic dissection using CT, because it allows not only to confirm the presence of pathology, but also to assess its distribution and depth of dissection.
Medical tactics. Treatment of chronic aortic dissection of the heart
For suspected pathology, the patient is hospitalized (in case of acute manifestations, he should be in the intensive care unit). Such a patient is monitored around the clock.
The method of choice is surgical intervention. The prognosis of surgery for acute dissection of the ascending aorta and its other departments is not always favorable, but if all the recommendations of doctors are followed, patients can live for 10 years or more. The recovery period after surgery takes place in a hospital. Drug therapy is carried out - in particular, drugs are prescribed to stabilize blood pressure. If the dissection of the aorta occurred against the background of some disease, it is necessary to carry out additional diagnostics and achieve recovery or stable remission.
Treatment of chronic dissection of the aorta of the heart or other departments includes:
- examination every 1-2 months by a doctor;
- stabilization of blood pressure;
- prescribing drugs to improve myocardial metabolism.
Such patients are registered at the dispensary, they are prohibited from engaging in certain types of work and sports, it is recommended to undergo sanatorium-resort treatment 1-2 times a year.
For chronic dissection of the aorta, folk methods of treatment can be used. Soothing teas stabilize blood pressure, stop the stressful state that can provoke delamination and rupture of the aorta.
Additional information about what are the causes of abdominal aortic wall delamination and what measures to take as prevention can be found on our website Dobrobut.com.
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