Coronary artery dissection (tear artery of heart)

Chest | Cardiology | Coronary artery dissection (tear artery of heart) (Disease)


The aorta is the large blood vessel that leads from the heart and carries blood to the rest of the body. The aorta originates at the aortic valve at the outlet of the left ventricle of the heart.

The aorta has a thick wall, with three layers of muscle that allow the blood vessel to withstand the high pressure that is generated when the heart pumps blood to the body. The three layers are the tunica intima, tunica media, and the tunic adventitia. The intima is the inside layer that is in contact with the blood, the media is in the middle, and the adventitia is the outermost layer.

Pain is the most common symptom of aortic dissection and is often described as tearing or ripping. The pain usually begins suddenly and is centered in the chest, radiating directly into the upper back. There may be associated nausea, sweating, shortness of breath, and weakness.

The patient may pass out. Other symptoms may be related to the location of the dissection within the aorta and whether it affects some of the branch arteries and occludes their blood supply. For example, if an artery that supplies blood to the brain is involved, there may be signs of stroke, or if the dissection affects the anterior spinal artery and blood supply to the spinal cord, the patient may present with paraplegia.

Causes and Risk factors

A coronary artery dissection (also known as spontaneous coronary artery dissection, or SCAD) is a rare, sometimes fatal traumatic condition, with eighty percent of cases affecting women. The coronary artery develops a tear, causing blood to flow between the layers which forces them apart. The condition is often seen to be related to female hormone levels, as well as other pre-existing cardiovascular conditions. In addition to this, a dissection can occur.

Diagnosis and Treatment

History and physical exams are most commonly performed. A coronary angiogram and/or CT angiogram will be done to indentify the injury. Depending on the severity of the defect treatment can include: coronary artery bypass grafting (CABG), stenting of the artery, or observation. ...

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