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What is Aortic Disease: Symptoms, Causes, Diagnosis, and Treatment

Definition and Overview

Aortic disease is a term that refers to a group of diseases affecting the aorta or the body’s main artery. This major blood vessel runs from the heart’s left ventricle and extends to the abdominal area, splitting into two branches known as the common iliac arteries. The proper function and good condition of the aorta are highly important as it is responsible for transporting and distributing oxygenated blood to and from the heart and the rest of the body.

Aortic diseases often lead to the dysfunction of aorta and disruption in blood circulation, which can be life-threatening.

Below are the different types of aortic diseases:

  • Aortic valve regurgitation. This condition is characterized by the inability of the aortic valve to close properly, leading to the blood flowing backward into the heart’s left ventricle instead of flowing into the different parts of the body. The regurgitation of the blood prevents the heart from functioning efficiently, leading to a number of symptoms such as fatigue and breathing difficulties. This condition typically develops over time, and in many cases, it takes years before the patient notices any signs or symptoms.

  • Aortic stenosis. This condition involves the narrowing of the aorta, which prevents the aortic valve from fully opening. It prevents the blood from flowing efficiently from the heart to the aorta, leading to inefficient blood oxygenation and circulation to the rest of the body. In such event, the heart will be forced to work harder to compensate for the condition. Over time, the overworked heart muscles can weaken and pose a serious threat to the life of the patient.

  • Aortic dissection. A dissection is a tear in the walls of the aorta, causing the blood to leak in the layers of the artery, where fluid is not supposed to be. This condition leads to the lack of proper amount of oxygen and other nutrients in the blood, which can result in serious risks and complications to various organs of the body.

  • Aortic aneurysm. An aortic aneurysm is the excessive enlargement of an artery, often leading to the weakening of its walls. The enlargement over stretches the tissues of the aortic walls; and when the aortic walls become too weak, they burst and cause excessive bleeding that can be fatal for the patient. These aneurysms can form in different parts of the aorta; research shows, however, that they are very common in the abdominal region of the aorta.

Aortic diseases should be caught and treated early. It is best for individuals to undergo screening for such diseases every year, especially if they are at high risk of developing any of the diseases described above. Chest MRI, ultrasound, arteriogram, and CT scans are just some of the available diagnostic imaging procedures that they can undergo.

Causes of Condition

The main cause of aortic disease is any impairment in the function and condition of the aorta, which in turn can have many causes, depending on the kind of disease the patient has.

  • Congenital heart valve disease - Patients with this condition are born with one or two leaflets, instead of three separate ones. In this condition, the valves do not close and open normally, and can cause regurgitation of the blood into the valve over time.

  • Endocarditis - this is an infection affecting the cardiac valves that can also damage the aorta and its ability to transport and distribute blood efficiently.

  • Exposure to rheumatic fever - Patients who were exposed to rheumatic fever, once a common childhood disease in different parts of the world, is proven by research as a leading cause of aortic valve disease in older patients.

  • Calcium build-up - Calcium, a mineral naturally found in the blood, can also accumulate in the aortic valves over time. This mineral can be left in trace amounts by the blood entering and leaving the aorta, and will not cause serious problems for healthy patients in certain amounts. However, people born with congenital problems in their aortic valves can suffer as a result of these calcium deposits, which can stiffen the leaflets or the opening of the valves.

  • Atherosclerosis, as research shows, is a major cause of aortic disease, because it leads to the weakening of walls of the aorta. Weak aortic walls are prone to dissection and aneurysms. Trauma to the aorta, on the other hand, can cause injuries such as dissections and lacerations.

Meanwhile, risk factors for aortic disease include:

  • The patient’s family history and genetic makeup (such as in the case of congenital or genetic abnormalities of the aorta)
  • Hypertension and high blood pressure can also increase the risk of aortic disease since high volume of blood passing through this main artery can weaken the aortic walls over time
  • Advanced age
  • Smoking

Key Symptoms

Aortic diseases have common symptoms since problems in the aorta typically lead to the improper circulation of the blood.

  • Always feeling very tired or fatigued
  • Feeling weak once activity levels are slightly increased
  • Breathlessness or needing to exert effort when lying down
  • Oedema, or the swelling of the feet and ankles
  • Discomfort, tightness, and pain in the chest
  • Dizziness, light-headedness, and frequent fainting
  • Arrhythmia, or irregular pulse
  • Palpitations, or abnormal quickening of the heartbeat
  • Heart murmur
  • Discomfort or pain in the abdomen or back

Who to See and Types of Treatments Available

A cardiologist is the medical professional to see if you suspect that you’re suffering from an aortic disease or if you’re experiencing symptoms described above. Depending on the severity of the condition and other factors (such as age, health, and possible risks and complications), the cardiologist can recommend medical management or surgery to restore the function of the aorta. Surgical options include transfusion-free surgery, open aortic repair, hypothermic circulatory arrest, endovascular surgery, and hybrid aortic repair.

Reference:

  • Otto CM, Bonow RO. Valvular Heart Disease. In: Bonow RO, Mann DL, Zipes DP, Libby P. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 66.