Sudden chest pain? People with high blood pressure should be careful! Huaxi doctors: This disease can be fatal!

Hypertensive patients, please take note

If you suddenly feel a tearing pain in your chest

I couldn't even move and started to lose consciousness.

It could be a very dangerous disease

Aortic dissection

Image source: Photo Network

The aorta has a three-layer structure, from the inside of the lumen to the outside, namely the intima, media, and adventitia.

The middle layer is the thickest and is mainly composed of elastin, which makes the aorta elastic. The three layers fit tightly together to ensure that the blood inside flows along the channel.

The pig throat that we usually eat in hot pot is actually the aorta of pig or cow. Think about its chewy, crispy and tender texture. Doesn’t it fit the structure of the aorta?

Once you are familiar with the structure of the aorta, you can understand aortic dissection.

Simply put, the innermost layer of the intima is torn for some reason, and blood enters through the tear, rushing through the intima and separating the middle membrane, forming a "false cavity", just like a balloon filled with water.

Image source: Photo Network

If the false lumen on this blood vessel ruptures accidentally, the person will quickly bleed to death.

When acute aortic dissection occurs, pain is the most common symptom.

The patient will suddenly experience severe pain in the chest, with a cutting or tearing sensation .

Image source: Photo Network

The location of pain varies depending on the location of the dissection. In addition to the typical chest pain, the pain may extend to the legs and up to the head and neck.

If it is chronic aortic dissection , the patient may not feel any discomfort, but this does not mean that there is no problem. It is more like an "invisible bomb" that may explode at any time.

The branches of the aorta supply blood to organs throughout the body. Therefore, in addition to pain, when the organs are not supplied with enough blood, symptoms such as fainting, palpitations, difficulty breathing, blood in the urine, abdominal pain, and lower limb necrosis may occur.

Hypertension, Marfan syndrome, smoking, drinking, bicuspid aortic valve, and atherosclerosis are the main risk factors for aortic dissection in my country.

These risk factors can make blood vessels fragile and more susceptible to damage. Aortic dissection can occur as a result of a violent sneeze or an argument.

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Among them, hypertension plays a dominant role in the occurrence of aortic dissection, so patients with hypertension should be especially wary of this occurrence.

Don’t wait until something happens to start regretting it. Pay attention and take out a notebook to write down these preventive measures!

Ways to prevent aortic dissection include maintaining a healthy lifestyle, controlling high blood pressure, having regular physical examinations, and following doctor's advice for treatment.

Controlling high blood pressure

Hypertension is the most important factor in the occurrence of aortic dissection and must be controlled!

Measure blood pressure regularly . If hypertension is found, treat it actively and take antihypertensive drugs as prescribed by your doctor to control blood pressure within the normal range (140/90 mmHg).

Image source: Photo Network

Maintain a healthy lifestyle

Eat: Eat a low-salt, low-fat diet, have a balanced diet, increase your intake of fruits, vegetables and fiber, avoid constipation, exercise regularly, and maintain a proper weight;

Sleep: Get enough sleep and don’t overwork yourself;

Heart: Maintain an optimistic attitude and avoid excessive emotions;

Exercise: Avoid excessive or strenuous exercise, especially for people at risk of high blood pressure or arteriosclerosis, who should choose moderate aerobic exercise;

Prevention: Avoid trauma as much as possible, and carry antihypertensive drugs and nitroglycerin with you when going out in case of emergency.

Regular medical check-ups

People with risk factors such as hypertension, arteriosclerosis, and family heredity (such as familial hypertension, Marfan syndrome, familial aortic dissection, etc.) should have regular physical examinations every year. Cardiac ultrasound and X-ray can help identify lesions early, and MRI and CTA can provide a clear diagnosis.

Image source: Photo Network

Aortic dissection is an acute and severe disease. If you experience any related discomfort, you should call emergency services or go to the nearest medical unit immediately.

Don't ever think that it will pass if you just endure it, as this will delay the best time for treatment.

At the same time, don't be too afraid. Although this disease is very serious, recovery is relatively good with timely treatment.

Hypertensive patients must pay attention to the prevention of the disease and change their lifestyles. Let us work together for our own health.

Statement: This article is a medical-related educational popular science article. It does not involve specific treatment methods or medical behaviors and cannot replace hospital visits.

Author

Zhou Yike, five-year clinical medicine program at West China University of Political Science and Law

Liao Yinghua, Five-year Clinical Medicine Program at West China University of Political Science and Law

Lee Seung-hee, Five-year Clinical Medicine Program at West China University of Political Science and Law

Sun Yan, five-year clinical medicine program at West China University of Political Science and Law

Chen Keyi, a five-year clinical medicine student at West China Medical University

Five-year clinical medicine program at West China Medical University

This article is guided by the teacher

References

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[2] Gao Wenbo, Yu Hongchi, Zhang Yaojia, et al. Research progress on the pathogenesis of thoracic aortic dissection[J]. Journal of Sichuan University (Medical Edition), 2023, 54(03): 699-704.

[3]Carrel T. Acute aortic dissection. Lancet. 2023 Mar 4;401(10378):773-788.

[4] Zhou Z. Risk Factors for Thoracic Aortic Dissection. Genes (Basel). 2022 Oct 7;13(10):1814.

[5] Interventional Medicine Group of the Radiology Branch of the Chinese Medical Association. Clinical Guidelines for Imaging Diagnosis and Interventional Treatment of Stanford Type B Aortic Dissection in China[J]. Chinese Journal of Radiology, 2023, 57(5): 457-473

[6] Vascular Surgery Committee of the Chinese Medical Doctor Association, Cardiovascular Surgery Branch. Chinese expert consensus on the diagnosis and treatment of aortic dissection[J]. Chinese Journal of Thoracic and Cardiovascular Surgery, 2017, 33(11): 641-654.

[7] Malaisrie SC.AATS Clinical Practice Standards Committee: Adult Cardiac Surgery. 2021 The American Association for Thoracic Surgery expert consensus document: Surgical treatment of acute type A aortic dissection. J Thorac Cardiovasc Surg. 2021 Sep;162(3):735-758.e2.

[8] Vascular Surgery Group, Chinese Medical Association, Surgery Branch. Chinese expert consensus on the diagnosis and treatment of Stanford type B aortic dissection (2022 edition)[J]. Chinese Journal of Vascular Surgery, 2022, 14(2): 119-130.

[9] Ogino H. Japanese Circulation Society, the Japanese Society for Cardiovascular Surgery, the Japanese Association for Thoracic Surgery and the Japanese Society for Vascular Surgery Joint Working Group. JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection. Circ J. 2023 Sep 25;87(10):1410-1621.

Content Production

Editor: Zhang Fuyao

Map: Eastern Zhou Dynasty