Undiagnosed BAV/TAD

May Take Life

Suddenly

How many deaths are due to aortic rupture each year? Because it is easily confused with a heart attack in the absence of an autopsy, the true incidence is unknown. Because there was an autopsy, it is known that Doug Grieshop’s aorta ruptured in his chest when he collapsed and died at the age of 33. He also had an undiagnosed BAV. Doug went to the ER with chest pain, 18 months before his death. A heart attack was ruled out, but his aorta was not checked. One morning at work, aortic rupture took his life almost instantly. Read Doug’s Story Here

Thoracic Aortic Disease (TAD) - Early Detection Early Detection and Monitoring The earlier thoracic aortic disease is found, the greater the opportunity there is to use all available medical knowledge and surgical skill to treat it. Early detection, expert evaluation, and ongoing care give the best opportunity to continue living an active, productive life. However, early detection can be difficult, and thoracic aortic disease is a serious condition. The aorta is exposed to a much higher blood flow than any other blood vessel in the body. A healthy aorta is strong and flexible, handling well the volume of blood flowing through it under pressure. If the wall of the aorta is diseased, it is like having a bulging, weak area in a hose under pressure. The hose may tear or break open completely. When the "hose" is the aorta, filled with blood, this can be very damaging and often is fatal. Aortic aneurysm and dissection are particularly treacherous because they may give little, if any, recognized warning. Unlike many illnesses, in some people there may be no ongoing pain or feeling of being sick that drives someone to persist in finding answers. Other people do experience symptoms such as chest or back discomfort, a hoarse voice, a cough, difficulty swallowing, or asthma-like symptoms. These are symptoms that may be caused by many things, and the connection with the aorta is not obvious. When severe chest or back pain develops, it may already be an emergency situation involving dissection. Even if there is no dissection, careful investigation is needed to determine whether this pain is a sign of a weak aorta combined with uncontrolled hypertension, or an indication of the presence of an established aneurysm that is growing in size. There is also danger because most people do not know that they have a condition that puts them at risk, such as a bicuspid aortic valve. They may have a history of aortic disease in their family and not realize it. If relatives have died suddenly and no autopsy was done, it often is assumed that they had a heart attack when they may actually have died of aortic dissection or rupture. In the emergency room it is typical for a heart attack to be the first suspect when chest pain is present. When the pain is from the aorta, a heart attack will be ruled out. Pulmonary embolism may also be suspected. However, unless the aorta is scanned, the real reason for the pain will not be found. At this point, anxiety may be suggested as the reason for the symptoms. So this condition is dangerous because someone with aortic pain or full blown aortic dissection may die in an emergency or hospital room, or be sent home again not knowing that their life is at risk due to aortic disease. Aortic dissection may happen whether or not the aorta is enlarged. When this tearing happens to the ascending aorta (Type A dissection), it is an emergency situation. Once it has torn, the thin outer layer is all that holds the aorta together. Emergency surgery is required. Type B dissection (intimal tearing of the descending and thoracoabdominal aorta) in the short term is generally less dangerous, as long as it does not rupture or cut off the blood supply to the lower body and its organs. Often, lowering and stabilizing blood pressure may be all that is needed immediately. A dissected descending aorta must be monitored because it may enlarge, actually becoming an aneurysm, and eventually require surgery. An aneurysm may either dissect or completely rupture. If an aneurysm dissects (intimal tear), survival will depend on where the tear happens and how quickly treatment is available. If an aortic aneurysm completely ruptures, bleeding is so severe that it is unlikely that anything can be done quickly enough.