Type-B aortic dissection - Distal

This is a severe disease due to a tear of the inner layer of the aortic artery in its descending segment. The aorta is the largest-calibre blood vessel of the organism.

The exact cause of dissection is unknown, but there have been reports of factors that contribute to its occurrence: build-up of fatty plaques on the artery, hypertension, smoking, aortic aneurysm, thoracic trauma, hereditary diseases, previous heart surgery, pregnancy and vasculitis.

It appears as very intense chest pain (very often described as "searing") which may radiate to the back and shoulder blades. There may be pain in other areas of the body such as abdomen and/or hips. Other accompanying symptoms: anxiety, feeling of impending doom, dizziness, fainting, nausea and vomiting, cold and clammy skin, a weak rapid pulse, asymmetric pulses, shortness of breath, abdominal pain and difficulty swallowing.

Diagnosis is reached through medical questioning and a full physical examination. Palpation and assessment of pulses on both sides of the body are important to identify asymmetries. The diagnosis will be confirmed through CT-scan.

The definitive treatment is emergency surgery. It must be controlled with painkillers and blood pressure medication for the associated pain and hypertension.