JANUARY–MARCH 2024 HEARTBEAT® 13 When blood gets between the layers, it, along with the oxygen and nutrients it carries, cannot get to the organs. This can affect the heart, brain, lungs, kidneys, arms and legs, and 40% of people with a dissection will die before reaching the hospital. Types of Aortic Dissection There are two types of aortic dissection: Type A dissections are more common and dangerous. They involve the upper (ascending) aorta — the part closest to the heart. The tear may extend through the descending aorta and toward the abdomen. This type requires immediate treatment/surgery. Type B dissections involve only the lower (descending) aorta and may also extend into the abdomen. Type B dissections do not always require surgery and, in some cases, may be treated with medication. Men are three times more likely to have an aortic dissection compared to women, yet research shows women have worse outcomes from aortic dissection. Approximately three- fourths of aortic dissections occur in those 40 to 70 years old, and individuals of Black African or Black Caribbean descent are also at higher risk. However, aortic dissections can affect people of all ages, races and sexes. Signs and Symptoms of Aortic Dissection Because symptoms can mimic those of other diseases, there are often delays in diagnos- ing aortic dissection, and it can be missed in the emergency department. However, when aortic dissection is detected early and treated promptly, the chance of surviving greatly improves. Get medical help immediately if any of these signs and symptoms are present: • Sudden, severe, sharp pain in the chest or upper back; also described as a tearing, stabbing or ripping feeling • Shortness of breath • Fainting or dizziness • Arm/leg weakness or pain • Sudden, severe abdominal pain • Low blood pressure • Rapid heart rate • Weak pulse • Nausea • Heavy sweating • Confusion • Loss of vision • Difficulty walking • Stroke symptoms Causes and Risk Factors Aortic dissection can occur for a number of reasons. Thus, it’s important to understand the causes and risk factors to determine if regular monitoring is recommended. High Blood Pressure High blood pressure (hypertension) causes the aorta’s wall to thin and deteriorate, so it’s logical that more than two-thirds of people who have an aortic dissection have high blood pressure. This can be due to being overweight, not exercising, eating too much salt, or eating too few fruits and vegetables. High blood pressure can also be a result of smoking, drinking too much alcohol or coffee (or other caffeine-based drinks), using stimu- lants or taking illicit drugs such as metham- phetamine or cocaine. While regular exercise can lower blood pressure, certain high-intensity activities such as weightlifting or other strenuous resistance training can bring on high blood pressure during the activity. Family history also plays a role in high blood pressure. Combine heredity with living in a shared environment and making similar unhealthy lifestyle choices, and the risk for high blood pressure increases even more. Stress is also a factor. When under stress, the body releases a surge of hormones, which cause the heart to beat faster and the blood vessels to narrow, resulting in increased blood pressure for a time.
