What is aortic disease and how can you dinguish it from a heart attack?

Aorta, a hard-working vessel that is the body’s largest artery and carries oxygen-rich blood throughout the body, is vulnerable to a number of disorders. Aortic diseases are pegged as silent killers because patients often have no symptoms, says Dr Dhanesh Kamerkar, Head of Department, Vascular and Endovascular Surgery, Ru Hall Clinic, Pune that is among the few in the country to set up an advanced centre dedicated to aortic disease. More often than not, back and chest pain along with difficulty in swallowing are believed to be symptoms of heart attack and stroke. However, a simple CT scan can reveal if the condition is related to aortic disease, in which case early treatment is paramount to positive clinical outcomes, says the expert.
What is aortic disease and what are its symptoms?
Shocking statics reveal that aortic diseases (AD) in various forms are the cause of millions of deaths across the globe each year. For instance, an abdominal aortic aneurysm (AAA) is one of the leading causes of sudden death in men above 60. Aortic diseases include aneurysms (ballooning and weakening of the arterial wall), aortic dissections (a tear in the innermost lining of the aortic wall), aortic occlusions (clots in the aorta) and even aortoarteritis (blood vessel inflammation more commonly seen in younger women). According to the Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC), aortic diseases may be clinically silent in many cases but a broad range of symptoms are indicators. These include acute deep, aching or throbbing chest or abdominal pain that can spread to the back, buttocks, groin or legs and best described as a “feeling of rupture.” Cough, shortness of breath or difficult or painful swallowing are indicators of Thoracic Aortic Aneurysm (TAAs). Constant or intermittent abdominal pain or discomfort, a pulsating feeling in the abdomen, or feeling of fullness after minimal food intake are symptoms to watch out for, according to Dr Kamerkar.
Aortic aneurysms usually occur in a weak spot of the aortic wall. Aortic aneurysms are the 13th leading cause of death in the US, accounting for an estimated 15,000-20,000 deaths annually.
What are the complications if AAA is left untreated?
AAA is a localised, bulging or abnormal enlargement of the abdominal aorta, most often impacting the infrarenal and aortoiliac arteries. Dr Purvez Grant, Chief Cardiolog and Chairman of Cardiovascular Services, Ru Hall clinic, said that untreated AAA can eventually rupture, leading to severe pain, massive internal bleeding and death.
So what are the risk factors?
While the risk increases with age, usually affecting people above 65, it is more common in men than women. According to Dr Kamerkar, there is a four to five times greater prevalence among males above 50 than females of the same age. A hory of smoking often accounts for more than 75 per cent of all aortic aneurysms. High blood pressure, high cholesterol, atherosclerosis and coronary artery disease are among the risk factors apart from familial incidence that is 15 to 25 per cent. Several genetic and lifestyle factors are known to increase the risk of aortic disease and early screening and treatment offer the best shot at living life to the fullest, according to Dr Grant.
Why do we need specialised centres?
As a sub-division of vascular disease, early diagnosis and treatment are crucial to saving lives. If someone has severe chest pain, the simplest thing to do is undergo an ECG. If it is normal, then a diagnostic test has to be taken to rule out aortic dissection. The incidence of such conditions is only increasing with ageing populations. Take for instance aortic dissections or a tear in the inner layer of the aortic wall. Known as a dissection, this causes the one or more layers of the wall of the aorta to come apart. This allows blood to flow between the layers, further weakening the walls of the aorta. “In order to combat this growing burden, an advanced centre dedicated to aortic diseases has been set up with latest technology for vascular care including a hybrid cath lab wherein both catheterisation and surgery can be performed in one suite.” Dr Kamerkar said.
What else is being done to create awareness about aortic diseases?
The Vascular Society of India, set up two decades ago, is pretty young with approximately 400 vascular surgeons. As a step to increase awareness, training programmes are being organised for doctors and healthcare professionals.