Aorta disease is an umbrella term for a group of heart conditions that affect the aorta, which is the main and largest artery in the human body that supplies oxygen-rich blood to all of the body’s organs. Diseases that affect the aorta can cause damage that jeopardizes the entire body’s blood supply and lead to life threatening medical emergencies.
There are many different diseases that can affect the aorta. An aortic aneurysm (either thoracic aortic aneurysm or abdominal aortic aneurysm) is when the aorta expands and can potentially cause the aneurysm to rupture. An aortic dissection occurs when the middle layer of the aortic wall splits and creates a “false” channel for blood flow, weakening the aortic wall and making it more prone to rupture.
Aortic infections can develop when an infected mass known as a septic embolism is found in the heart. This embolism can be made of a number of different materials including blood clots, cholesterol and fat. An aortic intramural hematoma is a condition where blood leaks through the innermost layer of the aortic wall and flows between the inner and outer walls. Bicuspid aortic disease occurs when a defect is present in the valve that opens and shuts to allow blood flow from the heart through the aorta, leading to less blood pumping through the body.
You may have an increased risk of developing aorta disease if you smoke tobacco, use stimulants, are not physically active, and do not maintain your blood sugar levels. Other risk factors for aorta disease include your family history and genetics, as certain aortic diseases can be inherited. The best method of preventing aorta disease is to make any necessary lifestyle changes before the disease develops, as prevention is much easier than treatment.
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The cause of aorta disease will typically depend on the type of disease you are experiencing, although common causes include high cholesterol, inflamed arteries, smoking tobacco, high blood pressure since the increased force of blood can weaken the blood vessels and artery walls, and genetic conditions such as Marfan syndrome, as this can interfere with the body’s ability to create healthy connective tissue.
As there are many different aorta diseases, and the symptoms are similar to other heart conditions, your doctor will conduct a variety of tests to rule out other possible causes and determine which aorta disease you have developed. Your doctor will begin with a basic physical exam and ask questions about your symptoms and family history.
Your doctor will then order tests such as chest X–ray, echocardiogram, chest or abdominal CT scan, chest or abdominal MRI, or thoracic or abdominal aortic angiography. These tests will evaluate the valves and chambers of the heart to diagnose any issues. Usually, more than one test is required to provide a proper diagnosis of aortic disease.
Treatment options for aorta disease will depend on which type you have been diagnosed with. Early detection of any aorta disease is greatly beneficial since aortic disease can typically be managed medically with frequent monitoring, medication and adjustments in lifestyle if detected early. Medications used to treat aorta disease include antihypertensives, drugs to lower blood pressure, or cardiac medications such as beta–blockers.
If medication is not enough to adequately treat your aorta disease, you may require surgery. Surgery to treat aorta disease can include minimally invasive procedures such as endovascular abdominal aneurysm repair (EVAR), which is where small incisions are made in the groin so that catheter tubes can be inserted into the aorta, along with a fabric-covered metal stent (endograft) that is fixed in place to relieve pressure on the artery and prevent rupture.
Another minimally invasive procedure is known as thoracic endovascular aortic repair (TEVAR), and in this procedure the surgeon will insert an endograft into the artery as a replacement for the diseased portion of the aorta. In more extreme cases, you may require open repair surgery to repair or replace the diseased segment of the aorta. In this procedure, the abdominal segment of the aorta is replaced with a prosthetic tube graft through an open incision.
Just as with the causes of aorta disease, symptoms can vary based on which form of aorta disease you are experiencing. However, there are many symptoms that can occur in a variety of different aortic diseases, such as a sudden stabbing or radiating pain, fainting, difficulty breathing, weakness in one side of the body, clammy skin, nausea and vomiting, or even shock.
Aorta disease can also sometimes mirror the symptoms of a heart attack, so you may experience chest pain or jaw discomfort. Since the aorta is the largest artery and spans all the way from above the heart to below the navel, symptoms such as pain can occur at any point along the torso.
If an aortic aneurysm does rupture, it will cause internal bleeding. The symptoms from a ruptured aneurysm are much more severe and can even cause life threatening complications. The aneurysm can also block the flow of blood from your heart to other organs, which may cause stroke or heart attack due to insufficient blood flow.
You can reduce the risk of developing aortic aneurysms by maintaining a healthy lifestyle. This includes eating a healthy diet and maintaining a healthy weight, as well getting regular physical activity. It is also important to quit using tobacco products and keep your cholesterol and blood pressure levels in check.
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Invasive therapies may also be used to treat an abnormal heart rhythm, such as electrical cardioversion which sends electrical impulses through your chest wall and allows normal heart rhythm to restart, or catheter ablation which disconnects the pathway of the abnormal rhythm. If your doctor determines that electrical devices are the best course of action, you may be given a permanent pacemaker, an implantable cardioverter-defibrillator (ICD), or biventricular (B-V) pacemakers and defibrillators.