Everyone is familiar with cardiovascular diseases such as coronary heart disease, cerebral hemorrhage, and myocardial infarction, and knows that these diseases can threaten our lives. However, few people know that aortic dissection is actually more dangerous than these diseases. In fact, aortic dissection is a very common and dangerous type of acute and severe illness in clinical practice, and if not diagnosed and treated in a timely manner, it can lead to death. So, what is aortic dissection? What tests can quickly identify it? How to treat and prevent aortic dissection? I will explain it to everyone.
1、 What is aortic dissection?
Aortic dissection refers to a critical condition in which blood in the lumen of the aorta enters the middle layer of the arterial wall through an intimal tear, forming a hematoma and expanding along the long axis of the blood vessel, resulting in pathological changes in the true and false lumen of the artery. It can quickly lead to death.
2、 What tests can quickly identify aortic dissection
1. Aortic CT angiography (CTA). CTA has high diagnostic value, and aortic CT enhanced vascular imaging can observe the aortic dissection dividing the aorta into true and false lumens. Reconstructed images can provide a three-dimensional view of the entire aorta.
2. Magnetic resonance angiography (MRA). Aortic MRA can accurately evaluate the true and false lumen and extent of aortic dissection.
3、 How to treat aortic dissection?
Patients in the acute phase, regardless of whether they receive intervention or surgical treatment, should first be treated with internal medicine drugs to control their vital signs such as blood pressure and maintain relative stability. Determine early surgical treatment or interventional stent implantation based on factors such as the extent of aortic dissection and disease progression. Severe cases can cause aortic dissection rupture, endangering the patient's life.
1. Drug therapy
effectively controls blood pressure and maintains blood pressure stability. Control blood pressure between 10-16kPa (75-120mmHg).
Propranolol can be used to reduce myocardial contractility.
Analgesia: For patients with low blood pressure and obvious pain, intravenous injection of morphine can be used; If severe pain is accompanied by shock, intravenous or blood transfusion should be given to correct shock and maintain blood volume.
Drug selection
Intravenous antihypertensive drugs such as sodium nitroprusside or nitroglycerin can be used; Metoprolol or Captopril can also be taken orally. Morphine is administered intravenously.
2. Surgical treatment - generally using minimally invasive surgery
different surgical methods are adopted according to the scope of the lesion involved.
Surgical indications are as follows: For proximal AD (all acute or chronic progressive lesions, combined with aortic reflux or aneurysm), surgical intervention (aortic root replacement) is the main treatment option. For remote AD, internal medicine medication should be the main treatment. Excluding progressive development of AD, or arterial branch involvement causing poor perfusion, ischemia, refractory hypertension, refractory pain, rapid development of aneurysm size and false lumen size. In addition, repeated imaging examinations are required for remote AD, which can be performed routinely (such as 7 days, 3 weeks, and then annually) and when there are any clinical or significant laboratory changes. If there are comorbidities, intracavitary repair surgery (including stents, occluded entrances, and open occluded branches) may be superior to surgical procedures in reducing mortality.
4、 How to prevent aortic dissection?
Here are some suggestions to prevent the risk of aortic dissection:
Control blood pressure. If you have hypertension, please seek medical attention promptly and monitor your blood pressure daily.
Don't smoke. If you smoke, please take smoking cessation measures and seek medical help if necessary.
Maintain an ideal weight. Adhere to a low salt diet, eat more fruits, vegetables, and whole grains, and exercise regularly.
Wear a seat belt while driving. This can reduce the risk of chest trauma.
Patients with hypertension should monitor their blood pressure at least twice a day to keep it within the normal range and avoid severe fluctuations. Moderate activity should be avoided to prevent the occurrence of diseases induced by vigorous exercise. Patients with aortic valve mitral valve malformation and Marfan syndrome should limit vigorous activity, undergo regular physical examinations, monitor changes in the condition, and receive timely surgical treatment to prevent the occurrence of aortic dissection.
In short. Aortic dissection is a critical cardiovascular disease that threatens life and health, and is currently one of the most complex and dangerous cardiovascular diseases. Therefore, we need to proficiently master the relevant nursing knowledge and emergency measures for aortic dissection, provide timely and effective treatment and prevention to patients, and improve their prognosis.