Aortic dissection - Definition, Types , Classification and Pathophysiology - Part 1 pathology USMLE

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Aortic dissection - Definition, Types , Classification and Pathophysiology - Part 1 pathology USMLE
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An Aortic dissection is a serious condition in which the inner layer of the aorta, the large blood vessel branching off the heart, tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect). If the blood-filled channel ruptures through the outside aortic wall, aortic dissection is often fatal.

Aortic dissection is relatively uncommon. The condition most frequently occurs in men in their 60s and 70s. Symptoms of aortic dissection may mimic those of other diseases, often leading to delays in diagnosis. However, when an aortic dissection is detected early and treated promptly, the chance of survival greatly improves.

Symptoms
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Aortic dissection symptoms may be similar to those of other heart problems, such as a heart attack. Typical signs and symptoms include:

Sudden severe chest or upper back pain, often described as a tearing, ripping or shearing sensation, that radiates to the neck or down the back
Sudden severe abdominal pain
Loss of consciousness
Shortness of breath
Sudden difficulty speaking, loss of vision, weakness or paralysis of one side of your body, similar to those of a stroke
Weak pulse in one arm or thigh compared with the other
Leg pain
Difficulty walking
Leg paralysis

Causes
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An aortic dissection occurs in a weakened area of the aortic wall. Chronic high blood pressure may stress the aortic tissue, making it more susceptible to tearing. You can also be born with a condition associated with a weakened and enlarged aorta, such as Marfan syndrome, bicuspid aortic valve or other rarer conditions associated with weakening of the walls of the blood vessels. Rarely, aortic dissections are caused by traumatic injury to the chest area, such as during motor vehicle accidents.

Aortic dissections are divided into two groups, depending on which part of the aorta is affected:

Type A. This more common and dangerous type involves a tear in the part of the aorta where it exits the heart or a tear in the upper aorta (ascending aorta), which may extend into the abdomen.
Type B. This involves a tear in the lower aorta only (descending aorta), which may also extend into the abdomen.

Risk factors
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Risk factors for aortic dissection include:

Uncontrolled high blood pressure (hypertension)
Hardening of the arteries (atherosclerosis)
Weakened and bulging artery (pre-existing aortic aneurysm)
An aortic valve defect (bicuspid aortic valve)
A narrowing of the aorta at birth (aortic coarctation)

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