Aortic dissection, a seemingly unfamiliar medical term, is a more terrifying disease than tumors, vividly referred to by medical personnel as the "bomb inside the body". There are approximately 5-10 cases of aortic dissection per million people annually, with a peak onset age of 50-70 years and a male to female ratio of approximately 2-3:1. Aortic dissection progresses rapidly, with a high early mortality rate and an overall mortality rate of approximately 30% to 50%. Once a blood vessel ruptures, it can cause death within a few minutes. If left untreated, the mortality rate within 48 hours of onset can reach up to 50%. Therefore, the popularization and publicity of aortic dissection is of great significance for improving public health awareness and preventing the disease.
The aorta is the main artery of the human body, which is the thickest and most pressurized blood vessel in the body. It is divided into ascending aorta, aortic arch, and descending aorta according to its shape, responsible for transporting blood from the heart to other parts of the body. Aortic dissection, also known as aortic dissection aneurysm, refers to the abnormal structure and hemodynamics of the aortic media leading to a rupture in the intima of the arterial wall. Blood enters the arterial wall through the rupture to form a hematoma, which further peels off the intima and media of the aorta. This condition makes the aortic wall fragile and prone to rupture, leading to a series of serious health problems.
The causes of aortic dissection are complex, including hypertension, older age, aortic atherosclerosis, hereditary vascular disease and other high-risk factors. In addition, unhealthy lifestyle habits such as long-term smoking, excessive alcohol consumption, and unhealthy diet may also increase the risk of aortic dissection. Therefore, for populations with these high-risk factors, regular physical examinations should be conducted to promptly detect and treat aortic dissection.
The clinical manifestations of patients with aortic dissection are diverse, but the most common is sudden and severe chest pain. This type of pain can radiate to the back, abdomen, lower limbs, and neck, presenting as a knife cut or tear that is unbearable. In addition, patients may also experience shock symptoms such as anxiety, sweating profusely, pale complexion, and rapid heartbeat. If the interlayer ruptures and causes bleeding, blood pressure may decrease. At the same time, patients may also experience cardiovascular symptoms, such as heart failure caused by acute aortic valve regurgitation, as well as changes in the pulse of the carotid, brachial, or femoral arteries. The rupture of the interlayer into the pleural cavity can lead to pleural effusion. In terms of neurological symptoms, the dissection may extend to the branches of the aorta or intercostal arteries, leading to cerebral or spinal ischemia, resulting in hemiplegia, coma, confusion, paraplegia, limb numbness, reflex abnormalities, as well as visual and urinary disorders. Dissection may also compress the abdominal and mesenteric arteries, leading to symptoms such as nausea, vomiting, abdominal distension, diarrhea, and black stool.
For the treatment of aortic dissection, effective analgesia and control of blood pressure and heart rate are first necessary to reduce the risk of aortic rupture. Pain relief treatment is crucial for patients with severe pain, as it can quickly alleviate the pain and prevent further expansion of the interlayer. Hypotension therapy is also a crucial step, which requires controlling the patient's systolic blood pressure within a reasonable range. Common antihypertensive drugs include nitroprusside, urapidil, and labetalol. After the condition and blood pressure stabilize, oral antihypertensive drugs can be used instead.
In addition to medication, surgical treatment is also an important treatment for aortic dissection. In recent years, with the advancement of medical technology, more and more patients have undergone acute phase surgical treatment to save their lives. Surgical methods include traditional open surgery and minimally invasive interventional surgery. Interventional surgery has the advantages of minimal trauma and fast recovery, and has become the mainstream surgical method. However, surgical treatment is not suitable for all patients, and doctors need to develop personalized treatment plans based on the specific situation of the patient.
In addition, daily life management for patients with aortic dissection is also very important. Patients should avoid vigorous exercise and emotional excitement to avoid worsening the condition. At the same time, maintaining a healthy lifestyle, such as quitting smoking and limiting alcohol consumption, eating a balanced diet, and following a regular schedule, can help reduce the risk of aortic dissection. For patients who have already suffered from aortic dissection, they should strictly follow the doctor's treatment plan and medical advice for treatment, timely follow-up and examination to monitor changes in their condition.
In summary, aortic dissection is a serious cardiovascular emergency with high risk. It is of great significance to improve the public's awareness and prevention awareness of aortic dissection through science popularization to reduce the incidence rate and mortality. At the same time, patients should actively receive treatment and improve their lifestyle to reduce the risk of aortic dissection. Let us work together to safeguard every life on the road to health.