Torn Aorta Affecting Holbrooke Impacts Thousands Per Year

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Each year in the United States, thousands of Americans experience a torn aorta, a life-threatening condition that is now affecting Richard Holbrooke, the US special representative for Pakistan and Afghanistan. According to CNN, Holbrooke was in critical condition at George Washington University Hospital on Saturday after he underwent surgery to repair the tear.

A torn aorta affects 10,000 Americans a year

The aorta is the largest artery in the body and is divided into five main segments: ascending, arch of aorta, descending, thoracic, and abdominal. Its main function is to distribute oxygenated blood throughout the body.

According to the American Heart Association, aortic dissection, or a tear in the aorta, occurs when the inner layer of the artery wall splits (dissects). High blood pressure is the most common risk factor that can cause a torn aorta, accounting for 62 to 78 percent of cases.

Aortic dissection can occur in the ascending aorta, located where the aorta originates from the left ventricle of the heart. This is known as the proximal aorta. When the aortic wall splits, the blood goes under the inner layer of the vessel, which causes the tear to worsen. Most often the tear continues away from the heart down the descending aorta and into the major branches.

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Symptoms of acute aortic dissection include sudden, severe chest pain associated with a cold sweat. The pain may be located in the front or back of the chest, and it usually worsens as the tear gets worse. Patients may also experience shortness of breath, nausea, fainting, and weakness. The condition is often misdiagnosed, and it can result in death. Actor John Ritter was 54 when he died of a torn aorta in 2003.

A torn aorta affects men from two to five times more often than it does women. The condition most often occurs in adults between the ages of 50 and 70. Holbrooke, who is 69, experienced symptoms on Friday December 10 during a meeting with Secretary of State Hillary Clinton. He was able to walk to the department’s medical unit, where he was taken by ambulance to the hospital.

A torn aorta requires emergency medical treatment, which typically includes immediate administration of drugs to lower blood pressure and heart rate, and often surgery. Aortic dissections of the ascending aorta usually require placement of an artificial graft. Dissection of the descending aorta, which is less common, may be treated with drugs alone in some cases.

Currently a national study directed by vascular surgeon Joseph V. Lombardi, MD, assistant professor of surgery, Jefferson Medical College of Thomas Jefferson University, is underway to evaluate the safety and effectiveness of an endovascular stent-graft to treat aortic dissection. If successful, the device could reduce the need for invasive surgical procedures and save thousands of lives.

According to CNN’s Chief Medical Correspondent Sanjay Gupta, the location of Holbrooke’s torn aorta “would determine what, if any, other side effects would occur.” Overall, the ten-year survival rate is more than 60 percent for a torn aorta.

SOURCES:
American Heart Association
CNN

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