Diagnosis
Detecting an aortic dissection can be a challenge because the symptoms are similar to those of many other health problems. Your doctor may think you have an aortic dissection if you have:
- Sudden tearing or ripping chest pain
- Blood pressure difference between the right and left arms
- Widening of the aorta on chest X-ray
Tests to diagnose aortic dissection include:
- Transesophageal echocardiogram (TEE). This test uses sound waves to create pictures of the heart in motion. A transesophageal echocardiogram (TEE) is a special type of echocardiogram in which an ultrasound probe (transducer) is guided through your esophagus and placed close to your heart. This test gives your doctor a clearer picture of your heart and aorta than would a regular echocardiogram.
- Computerized tomography (CT) scan of the chest. X-ray are used to produce cross-sectional images of the body. A computed tomography (CT) of the chest can confirm a diagnosis of aortic dissection.
- Magnetic resonance angiogram (MRA). An magnetic resonance angiography (MRA) uses a magnetic field and radio wave energy to create images of your blood vessels.
Treatment
An aortic dissection is a medical emergency requiring immediate treatment. Treatment may include surgery or medications, depending on the area of the aorta involved.
Type A aortic dissection
Treatment for type A aortic dissection may include:
- Surgery. Surgeons remove as much of the dissected aorta as possible and stop blood from leaking into the aortic wall. A synthetic tube (graft) is used to reconstruct the aorta. If the aortic valve leaks as a result of the damaged aorta, it may be replaced at the same time. The new valve is placed within the graft.
- Medications. Medications are given to reduce heart rate and lower blood pressure, which can prevent the aortic dissection from worsening. They may be given to people with type A aortic dissection to control blood pressure before surgery.
Type B aortic dissection
Treatment of type B aortic dissection may include:
- Medications. The same medications that are used to treat type A aortic dissection may be used without surgery to treat type B aortic dissections.
- Surgery. The procedure is similar to that used to correct a type A aortic dissection. Sometimes stents — small wire mesh tubes that act as a sort of scaffolding — may be placed in the aorta to repair complicated type B aortic dissections.
After treatment, you may need to take medication to control your blood pressure for the rest of your life. You may need regular CT scans or MRI scans to monitor your condition.