Signs and Symptoms
About 96% of individuals with aortic dissection present with severe pain that had a sudden onset. It may be described as tearing, stabbing, or sharp in character. 17% of individuals will feel the pain migrate as the dissection extends down the aorta. The location of pain is associated with the location of the dissection. Anterior chest pain is associated with dissections involving the ascending aorta, while interscapular (back) pain is associated with descending aortic dissections. If the pain is pleuritic in nature, it may suggest acute pericarditis caused by hemorrhage into the pericardial sac. This is a particularly dangerous eventuality, suggesting that acute pericardial tamponade may be imminent.
While the pain may be confused with the pain of a myocardial infarction (heart attack), aortic dissection is usually not associated with the other signs that suggest myocardial infarction, including heart failure, and ECG changes.
Individuals with aortic dissection who do not present with pain have chronic dissection.
Less common symptoms that may be seen in the setting of aortic dissection include congestive heart failure (7%), syncope (9%), cerebrovascular accident (3-6%), ischemic peripheral neuropathy, paraplegia, cardiac arrest, and sudden death. If the individual had a syncopal episode, about half the time it is due to hemorrhage into the pericardium leading to pericardial tamponade.
Neurologic complications of aortic dissection (i.e., cerebrovascular accident (CVA) and paralysis) are due to involvement of one or more arteries supplying portions of the central nervous system.
If the aortic dissection involves the abdominal aorta, compromise of the branches of the abdominal aorta is possible. In abdominal aortic dissections, compromise of one or both renal arteries occurs in 5–8% of cases, while mesenteric ischemia (ischemia of the large intestines) occurs 3–5% of the time.
Read more about this topic: Aortic Dissection
Famous quotes containing the words signs and, signs and/or symptoms:
“But I will harden Pharaoh’s heart, and I will multiply my signs and wonders in the land of Egypt.”
—Bible: Hebrew, Exodus 7:3.
“If family communication is good, parents can pick up the signs of stress in children and talk about it before it results in some crisis. If family communication is bad, not only will parents be insensitive to potential crises, but the poor communication will contribute to problems in the family.”
—Donald C. Medeiros (20th century)
“Social movements are at once the symptoms and the instruments of progress. Ignore them and statesmanship is irrelevant; fail to use them and it is weak.”
—Walter Lippmann (1889–1974)