The heart-wrenching pain is the emergency signal from the crutch of life

The heart-wrenching pain is the emergency signal from the crutch of life

"The pain you gave me left deep cracks" is from the lyrics of "Heart-breaking Pain". The "crack" in the lyrics can be used to describe the blood in the aorta cavity entering the aorta media from the tear in the aorta intima, causing the media to separate and form a cavity. After the aorta dissection occurs, the heart-breaking pain will appear according to the severity. Of course, the heart-breaking pain of the aorta cannot be compared with the pain of breaking up.

Where is the aorta located in the human body? What is its main function?

The aorta is the most important channel in the human body. It is located in the chest and abdominal cavity of the human body and is responsible for transporting blood from the heart to various organs throughout the body. The aorta is divided into the aortic root, ascending aorta, aortic arch, and descending aorta. The aorta is composed of three layers of intima, media, and adventitia that fit tightly together. The blood vessel wall is relatively thick. It is the thickest blood vessel in the human body, equivalent to the main water supply pipeline in a city.

The largest blood vessel in the human body: the aorta (Figure 1)

What is aortic dissection? Why is it so “terrible”?

1. The aorta is both a main channel and a storage container, and has an important function - rebound (pushing blood forward during the systole, while part of the blood is digested and absorbed by the elastic fiber tissue of the aorta. The blood that cannot be pushed out at the end of the systole is stored in the aorta, waiting for the next push.

2. The aorta is like a city's water supply pipe, which can corrode and burst. The aorta in the human body can also rupture, which usually causes sudden and severe tearing pain. In severe cases, it can cause breathing difficulties, fainting, shock and other symptoms. If you do not seek medical treatment in time, most people will eventually develop lumen rupture, massive bleeding and death.

3. How does aortic dissection occur?

Due to various causes, the middle layer of the aorta gradually degenerates and the elasticity of the aorta weakens. Under the continuous impact of the high-speed blood flow pumped by the heart, a hole appears in a certain part of the aorta's intima. The blood passes through the intima and enters the middle layer, tearing the middle layer with a certain thickness and forming another blood flow cavity in the middle layer. As the cavity gradually expands, the blood vessel wall becomes as thin as paper. At this time, a sneeze or forceful movement when going to the toilet will cause the blood vessel to rupture, and rupture means death.

What causes aortic dissection?

1. Hypertension: It is the main culprit of aortic dissection. Long-term irregular medication and poor blood pressure control will cause hypertension to exert excessive pressure on the aortic wall. When hypertension persists, this pressure will exceed the tolerance of the aortic wall and cause damage to its structure.

2. Abnormalities in the structure of the arterial wall:

1) Genetic gene mutation or genetic disease: Congenital gene mutation causes their elastic fibers and collagen fibers to strike or slack off in function, giving rise to dissection.

2) Lifestyle and environmental factors: Obesity, overeating, bad temper, high stress, high-load life pressure, etc., lead to damage to the endothelial structure of the aorta.

3. Atherosclerosis: High cholesterol, high blood pressure, smoking and diabetes are the main factors causing atherosclerosis, and its presence will seriously threaten the owner's health.

4. Aortic disease: Some congenital or acquired aortic diseases, especially aortic dilatation, may make the aortic wall fragile and increase the possibility of dissection.

5. Trauma: Severe trauma, such as car accidents, falls, sports accidents or other accidental injuries, may directly cause damage to the aorta and trigger the formation of dissection.

5. What are the symptoms of aortic dissection?

More than 90% of patients experience acute symptoms such as sudden sharp pain like a knife or tearing behind the sternum, a feeling of suffocation or even extreme fear of near death. Chest pain is not a disease, but it is really painful!

1) Clinical manifestations:

Aortic dissection has different symptoms depending on the severity and location of the tear. If you experience the following symptoms, call 120 immediately and seek medical attention.

(1) The first symptom of chest pain is sudden, persistent, progressive and severe chest pain, which is like stabbing, tearing or cutting, and is often unbearable. At this time, the patient sweats profusely and taking nitroglycerin sublingually is ineffective. Electrocardiogram examination excludes acute myocardial infarction.

(2) Hypertensive patients may appear to be in shock due to the severe pain, and may be anxious, sweating, pale, and have an accelerated heart rate. Many patients already have hypertension, and the severe pain after the onset of the disease causes their blood pressure to rise even higher.

Shock patients appear pale, sweat profusely, are nervous or faint, and have cold and wet extremities, but their blood pressure usually remains in the hypertensive range or decreases slightly. This is often the case when dissecting hematomas spread to hollow organs.

Gastrointestinal symptoms If the dissection spreads to the distal end of the aorta, the patient may experience abdominal pain, vomiting, hematemesis, and bloody stools. This is caused by the compression of the mesenteric artery by the dissection hematoma, which causes ischemic colitis.

(5) Neurological symptoms Aortic dissection can cause hemiplegia, coma, confusion, paraplegia, limb numbness, abnormal reflexes, and visual and bowel and urinary disorders.

(7) Urinary system symptoms: When the dissection affects the renal artery, low back pain or pain in the costovertebral angle may occur, and there may be a mass in the kidney area.

(8) Respiratory system symptoms: Breaking into the chest cavity causes hemorrhage in the chest cavity, which is more common on the left side. Airway obstruction, hoarseness, and even respiratory failure may occur.

(9) When the digestive system involves the abdominal aorta and its major branches, acute abdominal symptoms such as severe abdominal pain, nausea, and vomiting may occur.

2) How to prevent aortic dissection?

Three preventions, three controls, and one emphasis

Three protections: prevent kinematic hardening, prevent sudden and rapid forceful movements, and prevent trauma

Three controls: control blood pressure, control blood lipids, control blood sugar

First, pay attention to regular physical examinations

The risk factors of aortic dissection can be detected early, protecting human health.

Author: Li Die, Wang Yiying, Shi Wenhui

Layout: Jin Yi

Review: Li Ke

Image source: Internet (if there is any infringement, please contact us to delete)