Aortic dissection

Diagnosing an aortic dissection can be a challenge. Symptoms are like those of many other heart conditions. Healthcare professionals often diagnose an aortic dissection in an emergency setting. A care team quickly examines you.

If you have an aortic dissection, your pulse may be weaker in one arm or thigh compared with the other. Blood pressure readings may be different between the right and left arms.

Tests are done to check the heart and rule out other possible reasons for your symptoms.

Tests

Tests to diagnose aortic dissection include:

• Chest X-ray. This test shows the condition of the heart and lungs. If you have an aortic dissection, it may show a widening of the body's main artery.
• Transesophageal echocardiogram (TEE). This test uses sound waves to create pictures of the heart in motion. It creates these pictures from inside the body. This test gives your healthcare team a clearer picture of your heart and aorta than a regular echocardiogram.
• Computerized tomography (CT) scan of the chest. This test uses X-rays to make cross-sectional images of the body. A CT scan of the chest can confirm a diagnosis of aortic dissection.
• Magnetic resonance angiogram (MRA). An MRA uses a magnetic field and radio waves to create images of the blood vessels.

An aortic dissection is a medical emergency that needs treatment right away. Treatment may include surgery or medicines, depending on the area of the aorta involved.

Type A aortic dissection

Treatment for type A aortic dissection may include:

• Surgery. Surgery is done to remove as much of the damaged aorta as possible and stop blood from leaking into the aortic wall. A lab-made tube called a graft is used to rebuild 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.
• Medicines. Medicines can help reduce the heart rate and lower blood pressure. Lowering blood pressure can prevent the aortic dissection from getting worse. Medicines also may be used to control blood pressure before surgery.

Type B aortic dissection

Treatment of type B aortic dissection may include:

• Medicines. The same medicines used to treat type A aortic dissection may be used without surgery to treat type B aortic dissections.
• Surgery. Surgery for type B aortic dissection is similar to that used to treat a type A aortic dissection. Sometimes, small wire mesh tubes called stents may be placed in the aorta to keep it open. The stents are used to repair complicated type B aortic dissections.

After treatment for aortic dissection, you may need to take medicine for life to control blood pressure. You may need regular CT scans or MRI scans to check your heart and blood vessels.