The aortic dissection arises as a result of the penetration of blood into its wall due to disturbances in the structure of the inner shell. This pathology refers to the most common and dangerous acute diseases. Without timely treatment, aortic dissection almost always results in the death of the patient.
The main defect in this condition is the disruption of the vessel's middle shell.
The aortic dissection (ascending) occurs most often against the background of arterial hypertension. Degeneration in the middle coat (cystic necrosis medial) is observed in approximately 20% of patients. It can be accompanied by Marfan syndrome. This hereditary anomaly in connective tissue is characterized by skeletal and eye pathology, cardiovascular complications associated with destruction of the vessel walls, as well as insufficiency in the right atrioventricular valve and the aortic valve. Most patients with Marfan syndrome do not survive to forty years.
The aortic dissection (descending) often occurs accompanied by severe atherosclerosis and arterial hypertension. In rare cases, the condition is accompanied by cystic necrosis (medial).
Almost always destruction begins with tearing on the inner shell in one or more places. In the ascending aorta, it is noted, as a rule, two to five centimeters above its valve, in the descending - below the patch of the subclavian artery (left). The vessel in these places is relatively fixed, but mobile on each side. Thus, maximum hemodynamic stress is noted in these two sites of each systolic tremor. In this case, the inner shell can tear up at these points, contributing to the release of blood separating the walls of the vessel.
It should be noted that the symptoms of lesions and, mainly, the methods of their treatment are absolutely different with the dissection of the descending or ascending aorta.
Aneurysms of the thoracic part of the vessel develop, as a rule, asymptomatic, so patients usually do not make complaints. They are detected by x-ray or ultrasound examination by accident.
In some cases, when the aneurysm becomes large, there may be pain in the chest, neck, or back. In this case, compression of neighboring organs occurs.
Cough, shortness of breath;
- violation of swallowing;
Swelling of the neck and face;
Soreness can be persistent and resemble an attack of angina pectoris, however , it is not removed by nitroglycerin.
With an aneurysm of the abdominal aortic department, patients, as a rule, do not present complaints. The defeat is found by chance during research on other occasions. In a number of cases, patients are marked by increased pulsation in the abdomen and soreness or discomfort in the lower back or back.
Dissecting aneurysm of the aorta occurs when the integrity of the inner shell of the vessel is violated. In this case, the blood seeps into the middle layer and forms a cluster between the clusters.
Thus, there remains only one of three whole shell (external), if damaged, the vessel can burst, which will lead to death of the patient.
The rupture of the aneurysm in the aorta is accompanied by unbearable baking pains in the abdomen or chest, a sharp drop in blood pressure. The clinical picture at the same time is very similar to the manifestation of cardiogenic shock and myocardial infarction, which quite often misleads doctors.
Due to the fact that an aneurysm does not manifest itself in any way and is found accidentally, if it breaks, its symptoms develop incompatible with life, and the patient can not be helped, since the time to treat the still intact cluster is lost.