What Is an Aortic Dissection?
The blood vessels in your body are made of three layers. Sometimes a hole or tear can form between the layers, causing blood flow to then get in between these layers. Sometimes blood will stay in the middle of the layers, but other times blood will travel far inside the wall of the blood vessel.
Dissections can happen anywhere, but they most often happen inside the main blood vessel in your body, the aorta. If you have a dissection, you may need emergency surgery, but sometimes dissections can be treated with medicine depending on what vessels are involved.
Sometimes a dissection will not involve any branches and other times the blood flow that goes "inside" the wall of the blood vessel can get stuck and block blood flow to other important blood vessels in your body.
Having very high blood pressure is the most common cause of dissections. But sometimes there are some special circumstances where a person has a higher chance of developing a dissection because the walls of their blood vessels aren't as strong.
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Ascending & Descending Aortic Dissections
Your treatment plan will depend on where your dissection is and what blood vessels are affected.
Ascending Aortic Dissection
An ascending aortic dissection affects your aorta just after it leaves (or branches off) your heart. This type of dissection can affect the blood flow to your heart or to the branches that supply blood to your arms and brain. If you have a dissection in this location, it's considered a surgical emergency.
Descending Aortic Dissection
A descending aortic dissection affects your aorta after the branches to your arms and brain have already come off. Treatment will depend on what other branches are or are not involved with the dissection.
Doctors use lifelong strict blood pressure control to treat all descending thoracic dissections. If you have a descending dissection, the goal is to prevent further growth of the dissection.
How Is a Dissection Diagnosed?
Doctors will perform a CT (cat scan) with contrast of your chest, abdomen, and pelvis to both diagnose your dissection and the extent of the dissection (how bad it is).
Why Is it a Problem?
The blood that gets inside the layers of your aorta can block blood flow to the branches that come off your aorta.
If you have an ascending dissection, it can harm blood flow to your heart or brain. If you have a descending dissection, it can affect blood flow to your kidneys, intestines, or legs.
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Next Steps & Treatment
Treating aortic dissections depends on where they are and what branches they affect. You may need emergency surgery or just medical management.
If you have complications from your dissection, you may need surgery years after your original dissection happened.
University of Utah Health provides comprehensive care for aortic dissections no matter where they are or how many branches are involved.
