Newswise — Late on Sept. 11, a heart condition known as an aortic dissection took the life of award-winning actor John Ritter.
This tragic development puts a national spotlight on the deadly toll that aortic dissection takes every year, as one of the most sudden, unpredictable and hard-to-diagnose fatal heart conditions.
Nearly 10,000 Americans suffer aortic dissections each year, and nearly one in three dies before leaving the hospital despite recent advances in diagnostic tools and surgical treatment.
The University of Michigan Cardiovascular Center has some of the world's foremost experts on aortic dissection, who are available to speak with the news media in the wake of Ritter's death.
The U-M is the coordinating center for the largest-ever study of aortic dissection, and several U-M cardiologists have been the lead authors on several papers and meeting presentations on this topic, on behalf of the International Registry of Aortic Dissection (IRAD) study group.
U-M cardiac and vascular surgeons have extensive experience in repairing aortic dissections of both the ascending and descending aorta, including patients considered too high-risk for repair at other centers. And U-M radiologists are experienced at diagnosing the problem, which because of its symptoms is often mistaken for other cardiovascular conditions.
Note to editors: U-M physicians may be reached by calling the U-M Health System Public Relations office, 734-764-2220.
Background information on aortic dissection:
Those who have lived through it describe an aortic dissection as the most painful thing that ever happened to them. Blood, surging from the heart into the main artery, forces open a tiny rip in the aorta's lining that grows and threatens to burst like a dam in a flood.
While tears in the lining of the body's largest blood vessel are rare, occurring in 5,000 to 10,000 patients a year, they have long been known to be deadly. Without emergency attention and treatment — and even, often with it — the torn lining can continue to rip, block blood flow to the body, cause the heart to fail, or make the aorta swell into an aneurysm or even rip open.
Aortic dissections are the leading cause of death among people with Marfan syndrome, a genetic disorder that weakens the aorta and produces unusually long limbs or other abnormalities in more than 100,000 Americans.
Also at risk are people with other heart valve and aorta problems, high blood pressure, or a family history of aortic dissections. Some people with aortic dissection can achieve a stable state with their condition, at least for a while, but most cases are acute and must be treated quickly.
Aortic dissection's symptoms often mimic those of other cardiovascular conditions — resulting in delayed diagnosis. Symptoms include rapid onset of chest pain, sharp drops in blood pressure, altered consciousness, and limb paralysis.
Only when patients reach an emergency room and undergo tests and scans can the cause be spotted. The two best imaging techniques for finding a dissection are computed tomography, or CT, and the more specialized trans-esophageal echocardiography.
After diagnosis, ER staff may decide to send the patient to a hospital with the specialized staff and equipment to handle the condition - such as U-M and the other IRAD participating hospitals.
According to a study published by the IRAD group in the Jan. 15, 2002 issue of the journal Circulation, nearly one in three aortic dissection sufferers dies before leaving the hospital, despite recent advances in diagnostic tools and surgical treatment. The odds of death are even higher for women, patients over 70, and those who didn't or couldn't have surgery to fix the rip.
But besides showing aortic dissection's danger, the IRAD study's analysis of the largest and most representative group of patients ever studied is providing hope that more patients could get help quickly, avoid a mistaken diagnosis of heart attack or stroke, and be more likely to survive.
Based on their findings, the researchers have discovered key characteristics that can help identify patients who are more likely to die quickly - and therefore guide physicians and patients in making swift treatment decisions, including surgery or measures to prevent complications.
The researchers looked at the records of 547 patients treated at 18 large hospitals in six countries for type A acute aortic dissections, the most serious and most common kind of this rare condition. The researchers looked at 290 variables, from age and gender to blood pressure and previous medical history, to see which ones were statistically most common to those who died — or those who lived.
Another recent study by U-M surgeons documented the high incidence of aortic aneurysms among patients who have stable aortic dissections that have not yet ripped open. Aneurysms and dissections are different conditions, but patients who have aortic dissections must be carefully monitored for the rest of their lives, to catch aneurysms before they burst.
U-M vascular surgeons have also published results from their experience in repairing aortic dissection, showing a low mortality. Their paper offers information to help other surgeons achieve similar results at their centers.
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