2023-08-17 08:21:04
Aortic dissection and aneurysm threaten death
The aorta (aorta) is the blood vessel that emerges from the heart and transports blood from it to the rest of the body. It is like a garden hose, but it is slightly wider at the site of its exit from the heart.
vital artery
This vessel bends; Thick-walled, up and over the heart in the form of a soft arch, but becomes slightly narrower as you go down towards the middle of the body.
As with most heart problems, smoking and high blood pressure can increase your risk of developing problems with the aorta. The same goes for genes, and for some medical conditions that can weaken the artery wall.
As a result, the wall of the aorta may rupture (aortic dissection), in which a tear occurs in the inner layer of this main artery in the body and blood rushes out of the ruptured hole. Or the wall bulges out (or aortic aneurysm), or even an artery may rupture.
Although aortic disease is much less common than many other types of heart disease, a ruptured aortic aneurysm; It is often life threatening, which is why early detection, monitoring and treatment of this disease is vital.
In this context, Dr. Eric Eiselbacher, co-director of the Thoracic Aorta Center at Massachusetts General Hospital in the United States, says: “There is a real need to raise awareness of aortic disease, and this is not only among the general public; but also among the doctors themselves; This is because they sometimes do not pay attention to the risk factors and the importance of recommendations to conduct the necessary examinations.
Dr. Eiselbacher chaired the drafting committee for the updated American College of Cardiology-American Heart Association guidelines for aortic disease, which were published in November 2022.
Abdominal aortic aneurysm
Types of “aortic aneurysm”
* About 3 quarters of “aortic aneurysms” occur in the middle of the body, in the area below the kidneys, and this disease is known as “abdominal aortic aneurysms – AAAs)”, which often grows very slowly and does not cause any symptoms. But undetected disease can expand rapidly and rupture the artery without warning.
Screenings include a one-time simple abdominal ultrasound, which the guidelines recommend for those at highest risk; delusion:
Anyone with a family history of abdominal aortic aneurysm.
Men between the ages of 65 and 75 who have smoked at least 100 cigarettes over the course of their lives.
* Aortic aneurysms, TAAs, are classified according to their location in the body. As it is usually this problem, which occurs in the descending aorta (which is the part located after the aortic arch), is more common in elderly people who smoke and suffer from high blood pressure, as it usually occurs “aneurysm” in the ascending aorta ( the part closest to the heart) in younger people, and the condition may be linked to certain genetic conditions; Including the “bicuspid aortic valve”, which has two folds instead of the normal three.
About one in 100 people has a “bicuspid aortic valve,” says Dr. Eiselbacker, and half of them have an enlarged aorta.
When is the possibility of a “thoracic aortic aneurysm” examined?
An ultrasound of the heart (echocardiogram) can be used to check for a “thoracic aortic aneurysm,” but you must make sure that the report includes a measurement of both the aortic root (the part of the aorta that leaves the heart) and the ascending aorta, according to Advice. Dr. Eric Eiselbacher, Professor of Cardiology at Harvard University. CT scans are also used to check for “thoracic aortic aneurysms.”
You should undergo a “thoracic aortic aneurysm” examination in the following cases:
If you have a bicuspid aortic valve, had surgery to replace the bicuspid aortic valve, or have a parent, sibling or child with a bicuspid aortic valve.
If you had surgery to replace or repair the aortic valve before the age of 70.
If you have a parent, sibling or child with a thoracic aortic aneurysm or a ruptured aneurysm or aortic dissection.
If you have Marfan syndrome, Loeys-Dietz syndrome, vascular Ehlers-Danlos syndrome, Turner syndrome, or some other conditions other genetic.
Uncertainty about family medical history
If a person has a “thoracic aortic aneurysm,” there is a 20 percent chance that a family member will also have it. However, people do not necessarily know the details of their family’s health problems.
“Someone might say, ‘I think my father died of a massive heart attack,’ Dr. Eiselbaker says. ‘He grabbed his chest and fell dead before he got to the hospital.'”
Without an autopsy (which is uncommon), Eiselbacher adds, it is impossible to know the underlying cause of death, which could have been a ruptured thoracic aneurysm.
Therefore, the guidelines now consider anyone suffering from an “aneurysm” and any member of a family whose member died suddenly before the age of fifty, at increased risk of aortic rupture.
Usually, the risk of rupture in this artery increases as the size of the “aneurysm” increases, and therefore people who suffer from the presence of an “aneurysm” need to undergo periodic imaging examinations to check the extent of the size of this expansion, and if it reaches a certain threshold (which varies according to people), doctors may recommend surgical intervention, which must be performed in a large medical center by a team of specialists in diseases of the aorta, says Dr. Eiselbacher.
* «Harvard Letter to the Heart» – «Tribune Media» services
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