How can I prevent wall plaster cracks
With an aortic dissection, wall tears occur in the inner layer of the main artery (aorta) without the outer layer of the vessel wall being interrupted. This can occur spontaneously or after heavy exertion, often directly related to high blood pressure. As a result, the blood digs its way between the two inner wall layers and the outer wall layer of the main artery. The patient usually feels an unprecedented, knife-prick-like pain between the shoulder blades that travels down the spine. The main danger with dissections is that there may be insufficient blood supply to organs or limbs because important side branches of the main artery are blocked or narrowed. Occasionally, the pressure on the outer layer can be so great that it tears and severe bleeding occurs. Then the patient is in a life-threatening situation.
In order to avoid insufficient blood flow to the heart and brain, acute dissections close to the heart are operated on in an emergency operation by a cardiac surgeon. Dissections that primarily affect the thoracic or abdominal artery are initially treated conservatively, that is, by lowering blood pressure with medication and using pain relievers. Insufficient blood flow to the abdominal organs or legs can often be improved by inserting a stent graft. Occasionally, the membrane that has torn has to be windowed by catheter technology. This can prevent open operations in the acute phase of the dissection. Regardless of the type of treatment, patients with aortic dissection must be checked for life because the wall layer of the main artery remains weakened after the tear. The diameter of the main artery begins to grow slowly as a result. In about a third of patients, an open replacement of the main artery is necessary after months or even many years because the main artery has reached a diameter of six centimeters (see chapter "Thoracic artery aneurysm"). Treatment with a stent graft is often not possible in this situation. Patients after aortic dissection are checked for life in our aortic consultation.
The incapacity for work is usually three months. It is important that patients after an aortic dissection - regardless of whether they have been operated on or not - take care of themselves physically and under no circumstances are subjected to a strict training program in the first six months! Physical performance is of secondary importance in this phase, when the main artery is most vulnerable. After six months, the patients are asked to come to the aortic consultation for a clinical and X-ray follow-up. Before this, computed tomography or MR angiography (MRI) is usually done on the same day. We recommend avoiding carrying weights over five to ten kilograms for three months and not lifting more than 20 kilograms for a lifetime. Patients with aortic dissection should remain under long-term medical control. Only when the main artery is stable do the intervals between the controls become longer and in the best case can be done every five years.
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