Aortic dissection most commonly causes severe pain from the chest to upper back, and often occurs at midnight or early morning, so people with the “three highs” — high blood pressure, high blood lipids or high blood sugar — should keep warm when getting out of bed to prevent sudden cold-induced high blood pressure, a doctor said.
Former minister of transportation and communications Kuo Yao-chi (郭瑤琪), aged 69, was rushed to Shin Kong Wu Ho-Su Memorial Hospital in Taipei for emergency treatment due to an aortic dissection on March 23 and was pronounced dead the following day.
Fu Jen Catholic University Hospital’s Cardiovascular Surgery division director Yu Hao-chun (游皓鈞) said that the aorta plays an important role of carrying oxygen-rich blood from the heart to the rest of the body, which first goes to the arms, hands and brain, then to the inner organs and the lower limbs.
Photo: CNA
The aortic wall has three distinct layers, each with specific functions and connecting to various body structures, he said.
Aortic dissection is when a tear occurs in the inner layer of the aorta, and as blood rushes through the tear, it causes the layers of the aortic wall to split, Yu said.
The condition can have an inherited component, such as Marfan syndrome or certain congenital heart conditions, he said, adding that most aortic dissection cases are caused by lifestyle factors, such as smoking or poor control of the “three highs.”
The hallmark symptom of aortic dissection is sudden, severe chest to back pain, often associated with a cold sweat from severe pain, so when emergency doctors hear patients describe similar symptoms, they would usually arrange an immediate CT scan, Yu said.
However, sometimes patients might present atypical symptoms, such as chest tightness, lower abdominal pain or leg weakness, which are more difficult to accurately diagnose, he added.
“Aortic dissection is strongly associated with high blood pressure,” Yu said, adding that blood pressure is often higher in the early morning, usually dropping near noon and gradually increasing in the evening.
As aortic dissection often occurs at midnight or early morning, people with the “three highs” should take medicine accordingly and wear a jacket when getting out of bed in cold weather, because sudden cold exposure can cause a spike in blood pressure, he said.
The best way to prevent aortic dissection is to control one’s blood pressure, keep a healthy body weight, get plenty of sleep and maintain a habit of exercising regularly, Yu said.
People should also eat low-sodium and low-fat meals, maintain stable emotions, and avoid behaviors that cause a spike in blood pressure, he added.
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