The silent enemy: Aortic dissection

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The silent enemy: Aortic dissection
4.03.2021

In order for the organs and systems in our body to function properly, they need oxygen. Oxygen and other substances that the body needs are carried to the body by the blood circulating in our veins. After the blood is pumped from the heart, it is distributed to other organs through the aorta, the largest artery in our body.

The aorta is a very large vessel, the high-pressure blood pumped from the heart moves along the aorta, branches off along its course and ensures that clean blood is delivered to every point from our brain to our feet. Briefly, the aorta is the "main blood line" responsible for feeding our heart, brain and all other organ systems. can be thought of as Depending on the age and size of the person, the blood carrying capacity can reach from 3 to 6-7 liters per minute.

The aorta is extremely flexible and resistant to high pressures. It continues to function for many years without any harm in healthy individuals without familial predisposition. Where it exits the heart is where the aorta is at its widest and ranges from about 2.2-3.0 cm; As age advances and body mass increases, aortic width may increase up to 3.5 cm, which can be considered normal. When it is divided into branches, its width gradually decreases, it ends by dividing into two at the groin level, and from here on, the great veins that feed the legs and feet continue.

The flexible structure of the aorta helps the vessel wall to expand and contract when necessary against high-pressure blood flow, thus protecting itself against possible damages. This flexibility is provided by the layers in the wall of the aorta. The aortic wall consists of 3 layers, and thanks to the elastic fibers between these layers, the aorta can expand just like a rubber balloon and then return to its former form, in this way, it not only protects itself from high pressure, but also allows the blood to flow further and further. It helps to advance to the organs.

What does aortic rupture mean?

ÖFirst of all, there can be two situations that are meant by aortic rupture. One of them is the rupture of all 3 layers of the aortic vessel wall, medically AORT RÜPTÜRÜ is named. Aortic rupture As a result, the blood carried in the aorta suddenly empties into the body cavity and the organs cannot be fed, it is an extremely fatal condition and requires emergency surgery.

Aortic rupture, which is more common in the community and in the colloquial language, is "aortic rupture". Another condition, called AORTIC DISSECTION, is the innermost condition in the aortic wall. It is the situation that occurs as a result of the rupture of the layer. In this situation, "skipping" in the aortic wall rather than a tear. It will be easier to visualize if it is expressed as, inside the wall. As a result of a rupture in the part of the aorta, blood fills between the layers, the layers of the aortic wall gradually separate from each other like a zipper with the effect of the blood filled, and the blood continues to fill this space.  As a result, sufficient blood cannot be transported to the organs, sudden shock and organ failure develop in patients, which may result in the death of the person. It was aortic dissection that caused the death of her artist Oya Aydoğan. The pressure created as a result of the artist's violent coughing to remove the bite stuck in his throat caused the aortic vessel to jump and rupture, and unfortunately, despite all the emergency interventions, the artist could not be saved. p>

Aortic dissection, which is seen with a frequency of 5 to 30 per million worldwide, results in a 40% death rate. In our country, about 350 cases of aortic dissection occur every year. It is generally seen in the age range of 60-80 years, the incidence in men is 2-3 times higher than in women. It appears Both conditions are rare but life-threatening and serious conditions that require immediate attention.

Can my aorta rupture when I cough?

In healthy people, movements that increase the pressure in the chest, such as coughing, straining, sneezing, do not cause any damage to the aorta, a healthy aorta is extremely healthy. However, if there is a previous damage to the aorta, arteriosclerosis, calcification, ballooning (aneurysm), a previous aortic surgery, or if the person has a genetic connective tissue disease (Marfan or Ehlers Danlos syndrome), congenital People with 2-valve aorta (bicuspid aorta) or congenital aortic stenosis are at higher risk of aortic dissection.

Severe pressure such as traffic accident or high chest/fall on backccedil; In cases that cause injury, the aorta of healthy individuals can also rupture.

Especially high blood pressure wears out the aorta over time. High cholesterol also triggers plaque on the vessel walls, causing arteriosclerosis. With the combination of advanced age and other diseases that cause arteriosclerosis, people become more risky for aortic rupture.

People in these risk groups should have their annual cardiological check-ups, periodic measurements should be taken in case of a possible enlargement of the aortic vessels, blood pressure and cholesterol levels should be followed closely, and both nutritional regulations and medicine Concomitant diseases should be brought under control with treatment.

How do I know if my aorta is torn?

Sudden, stabbing or cutting, severe back or chest pain usually indicates aortic rupture. Symptoms may vary depending on the area where the tear occurred. Sudden fainting, paucity or coma, abdominal or chest pain or pain in the legs may be seen, the pain may be migratory. When you show such symptoms, you should apply to the nearest emergency room without waiting and the necessary interventions should be done as soon as possible. For every hour that passes after the rupture, the risk of death increases by 2%.

How to treat?

40% of aortic rupture cases result in death. The chance of treatment for the remaining 60% varies according to the time taken until they come to the hospital, the torn area and treatment options. After aortic rupture, the only treatment is vessel exchange, either open or closed; For this reason, simple measures such as preventing tearing and controlling risk factors, going to regular doctor check-ups, quitting smoking, keeping blood pressure and cholesterol diseases under control, and regular exercise are the real saviors.