Risk factors for aortic dissection
Since aortic dissection is an acute and life-threatening clinical picture, there are no warning signs in advance. However, there are risk factors that favour aortic dissection. The most important of these include high blood pressure, fatty deposits in the aorta (arteriosclerosis) and hereditary diseases – e.g. Marfan syndrome, Ehlers-Danlos syndrome, vasculitis. In the presence of one or more of these underlying diseases and their acute onset, such as chest pain, shortness of breath, blood pressure crises or paralysis, an aortic dissection should be considered as the cause and a doctor should be consulted immediately, or the emergency medical services should be alerted.
The different types of aortic dissection
Two types are distinguished depending on the location of the aortic dissection: Aortic dissection type A and B. Type A is a dissection of the vessel wall in the ascending part of the aorta and type B is a dissection in the descending part further away from the heart. Type A aortic dissection in particular requires very rapid recognition and action due to the proximity to the heart and the arteries supplying the head.
Specific complications of type A aortic dissection are myocardial infarction with sudden stabbing pain or a feeling of pressure behind the breastbone, possibly radiating into the left shoulder and jaw. There is often shortness of breath and palpitations, sudden onset of headache and associated neurological loss symptoms such as speech or gait disorders or paralysis. In type B aortic dissection, the entire descending aorta can be affected, up to the point where it branches off into the arteries supplying the legs.
For this reason, type B dissection is characterized by symptoms such as acute abdominal pain due to reduced intestinal supply, acute renal failure and paraplegia. However, a combination of symptoms can also occur, in which both the ascending part of the aorta and the descending part are affected.