All chest pains are not the same. It could be mild and be caused by things other than heart problems, like heartburn or stress. Or, it could be a lot worse and even kill you, like when an aortic dissection is to blame (tear in the large artery near the heart).
Even in hospital emergency rooms, aortic dissections are often misdiagnosed as less serious conditions. Because of this, it is important for people to know if they are at risk and how to avoid a tragedy.
The number of cases of aortic dissection that are reported each year is between 5,000 and 10,000. The main sign is usually a severe, tearing or "ripping" pain in the chest or lower back, but there are also other signs like a fast heartbeat, sweating, nausea, a weak or nonexistent pulse, and less feeling in the limbs. Aortic dissections need to be treated right away because they can cause a lot of internal bleeding and even death.
People who have high blood pressure, Turner syndrome (a disorder of the chromosomes), or a history of aortic disease in their family are more likely to have an aortic dissection. Also, people with Marfan syndrome are up to 250 times more likely to have a heart attack because the connective tissue in their aorta is so weak. Many people with Marfan syndrome, on the other hand, are not diagnosed and don't know that aortic dissection can cause them to die suddenly and young.
The National Marfan Foundation (NMF) wants people with visible signs of the disorder, such as being tall with long arms and legs, a chest bone that is indented or sticks out, flat feet, long fingers and toes, and eye problems, to get checked out. A deadly dissection can be stopped with medicines, surgery, and changes to the way people live.
Diane Sixsmith, M.D., chair of the Emergency Medicine Department at New York Hospital in Queens, says that people who are more likely to have an aortic dissection should take more care. "Those who are at risk for aortic dissection are more likely to live if they are diagnosed and treated quickly," she says. "Don't wait for a tragedy to find you if you are in a high-risk group, and especially if you have Marfan syndrome. Patients do very well if they get regular echocardiograms and take medicine to slow the heart rate and pulse. Preventive surgery (done before the aorta splits) has a success rate of more than 98 percent."
