Aortic Dissection

For my STEAM project, I chose to discuss aortic dissections, which relates back to unit 11, the cardiovascular and circulatory system. The reason that I chose this topic is that after learning about both the cardiovascular and circulatory systems, I wanted to know some of the problems that could go wrong, how they would be treated, and how they can affect the body. I chose to discuss the ways that aortic dissections affect the body, how to detect an aortic dissection, and how it can be treated. For my art piece, I chose to draw how a regular artery looks compared to how an aortic dissection looks.

An aortic dissection is a life-threatening condition that is characterized by the separation of layers within the aortic wall due to an intimal tear, which causes blood to flow into a false lumen. Although this condition is rare, it can carry a high mortality rate if it is not immediately diagnosed or treated. By being able to understand its pathogenesis, the risk factors, and treatment options is important because it can help achieve better outcomes for this condition. The pathophysiology of an aortic dissection involves the medial degeneration of the aortic wall, which is what weakens its structure. Factors that determine this condition include things like hypertension, genetic disorders, and inflammatory conditions. According to Watanabe et al. (2013), most of the dissections start with an intimal tear that allows the blood to enter the media, which creates a false lumen. This false lumen can then compress the true lumen, impairing organ infusion, or even rupture, which could cause a hemorrhage that can be fatal.

Aortic dissections can be classified by using the Stanford system into type A (involves the ascending aorta) or type B (does not involve the ascending aorta) for treatment. Type A requires immediate surgical intervention because of the high risk of cardiac tamponade, aortic valve involvement, or a stroke. Type B dissections is able to be controlled through blood pressure control unless problems occur, such as a rupture or an organ ischemia (Watanabe et al., 2013). Inflammation also plays a role in the development of an aortic dissection. Research that was done by Wu et al. (2021) emphasizes the contribution of inflammatory mediators and immune cell infiltration in promoting aortic wall remodeling and degeneration. Wu al. (2021) also stated that immune mechanisms, particularly macrophage activity, can maintain tissue damage, which suggests that anti-inflammatory therapies control the progression of this condition.

To diagnose an aortic dissection, imaging must be done. Computed tomography angiography (CTA) is what is recommended to diagnose this condition due to its high sensitivity and specificity. Echocardiography and magnetic resonance imaging (MRI) can also be used, especially with patients who have contraindications to contrast media. Symptoms may include a sudden, severe chest or back pain, pulse deficits, or neurological symptoms. Strategies to manage this condition include controlling blood pressure and heart rate by using beta-blockers and vasodilators.

In the end, I learned that an aortic dissection can be fatal due to internal bleeding or organ damage.

References

Group, N. J. J. W. (2013b). Guidelines for Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection (JCS 2011). Circulation Journal, 77(3), 789–828. https://doi.org/10.1253/circj.cj-66-0057

Shen, Y. H., LeMaire, S. A., Webb, N. R., Cassis, L. A., Daugherty, A., & Lu, H. S. (2020). Aortic Aneurysms and Dissections Series: Part II. Arteriosclerosis Thrombosis and Vascular Biology, 40(4). https://doi.org/10.1161/atvbaha.120.313804