Aortic Dissection Puns

Question! How common are aortic dissections in the general population? Are they more common in men or women? If someone presents with chest pain, slight shortness of breath, and palpitations would this warrant further testing? Blood levels for trop, d-dimer, CBC all normal. Is this something that is common in a younger population and who is at risk? What are the symptoms of this and how severe are they?

Also, would an ECG and chest X-ray give light to the diagnosis of this as well?

Curiosity!

Nursing student

My dad (58M) was rushed to the hospital for emergency open-heart surgery due to a type A aortic dissection about a week and a half ago. Happy to share he is on the mend and feeling better every day! Unfortunately, he is now convinced that getting his vaccine is what did him in.

He's a conservative-leaning guy but likes to think of himself as rational and logical. So I really cannot understand the irrationality behind his current thinking. Basically:

1. In 2019 he had some sort of scan that showed all of his organs were healthy/functioning well.
2. He got the Pfizer vaccine in April of this year.
3. He says that "ever since he got the vaccine" he gets random pains in that left arm.
4. "All of a sudden" now in November he has this crazy medical emergency, even though no one else in his family had heart disease.
5. Thus, the vaccine is what caused this emergency.

Ok, here's some context that's missing from his narrative:

1. He works a high-stress labor job and has been working 60+ hours a week on average throughout the pandemic.
2. He literally has high blood pressure and high cholesterol. He is 5 ft 5, probably 175 lbs.
3. He doesn't actually eat that healthy and hasn't gone to the doctor since that 2019 scan.
4. Both of his parents and one of his siblings are dead, all 3 from serious health conditions, albeit not heart disease.
5. His girlfriend, his ex-girlfriend, almost of his friends, and living family are antivax/dabble in all sorts of right wing conspiracies.

I know this is probably in vain, and I understand his brain is building a narrative to cope with the trauma of what's happened, but I am so afraid that he's going to put himself in harm's way by suddenly becoming anti-vax. He is starting to go down a rabbit hole on Youtube and has lots of people in his life egging this on. Despite being the only educated person he really knows, he does not seem to hold my word in very high regard (probably because I've been indoctrinated by Big University or something).

So for my own peace, and maybe an ability to reason with him, what causes an aortic dissection? How can one prove it has literally nothing to do with an inoculation you received 6 months ago?

TLDR; My dad thinks his aortic dissection is due to him getting the vaccine. How can one explain that this is an unreasonable theory?

EDIT: I don’t think conservative people aren’t rational human beings. I simply meant that he has not been part of the bigger conservative anti-mask anti-vax movement in

So this is gonna be a long one i hope somebody can help me,

When i was 19 i was training to partake in a powerlifting competition and as many of my friends i too injected testosterone (around 350mg a week) to enhance my lifts. I also took a lot of "pre workout" supplements that contained stimulants as caffeine, taurine and some of them even contained Amphetamines. In a week when i was deadlifting almost every day i hit a new PR with 210kg and immideatly aimed for a Dropset with 10 repetitions with 170kg. When i did these lifts i always used to hold my breath as its common in Powerlifting because you are able to lift more weight. On the 6 or 7 rep i collapsed with severe Pain in my Trap area and my right arm turned blue.

Other People at the gym called an ambulance for me as i was unable to move. In the Hospital they gave me strong pain medication (Morphium) twice so i barely felt any pain. At first the doctors could not find anything so they just said i ripped a muscle and needed some rest so they send me home a day later.

Going out of the Hospital with great pain they just told me to suck it up basically and that this is normal. A few hours later i collapsed again as i was trying to masturbate and beeing close to orgasm the bulge in my artery that builded up when doing the Deadlift (the cause of my first collapse) ruptured and started to bleed inside my lungs. This time i felt the worst pain i have ever felt and was barely conciouss because of all the pain. My brother found me on lying on the floor a few minutes later and called for an ambulance again. This time they gave me really strong medication (dont know what exactly) but i have not felt a thing and even saw gnarfs and all kinds of beeings. After they put me in an MRT they took me to another hospital and made an operation there to put in a stent because my Right arm artery had dissected and ruptered. Woke up in the Hospital with all kind of machinery hanging out of my Shoulder, Lungs etc.

I was devastaded but the doctors told me its my second birthday and that i should be happy about it. Also they hurt an nerve responsible for your vocal cords so from that point on i had an unilateral vocal cord paralysis and had trouble speaking for the next months. Speech therapy helped somewhat but it never got back to normal.

This was the start for my real life as before i was not even living compared to now. It was the catalysator for me to start searching for something more than this physical reality becau

I think Dr Wen is a general surgeon, he’s talking about his lapcholi with Turk a few episodes before

And how many years have you been practicing?

I feel like I've seen hundreds of chest pains.... I always wonder how many I've missed.

The only one I've "diagnosed" after 3 years I dont even count... history of aortic dissection coming in for chest pain that radiates to the back... confirmed to have worsening dissection on scan... but that's a no brainer

32F, 212lbs, 5’9, diagnosed ehlers danlos syndrome hyper mobile type (but have never been tested for vascular type).

I know that you usually die within a week with aortic dissection but I have connected with people, especially young women for whom there was a low clinical suspicion, who survived and weren’t diagnosed until months or years later after symptoms.

In February of this year I had ripping upper back pain between my shoulder blades and stabbing epigastric pain that came on quite suddenly along with panic attack symptoms that I have never had before in my life. I was also nausous, couldn’t pass gas and could not eat without pain. My HR was 130 I also noticed my aorta was pulsing out of my abdomen.

I went to the ER and they did a chest X-Ray and abdominal ultrasound and found nothing. No gallbladder problems. GI did endoscopy and found nothing — no hiatal hernia. Two months later I went back with chest pain and they found elevated D-dimer, CRP, and pleural effusions and pneumonia which they said was “weird.” But just gave me antibiotics and sent me home.

They also did a chest CT and saw “no evidence of dissection” but they they also said there was motion artifact.

From an article: “Subtle dissections limited to the aortic root and proximal aorta can be dismissed as artefacts. EKG-gated or triggered CT scans reduce motion artefacts and have been shown to improve diagnostic accuracy [10,11], but this imaging modality is not routinely used in all centers.”

I have not gotten better since the antibiotics. But now it feels like whatever was ripping in my upper back has ripped down to my lower back and my ribs are sliding down under my skin. My diaphragm does not feel attached in the back and it’s difficult to breathe. I also feel a weird floating membrane in my abdomen.

I also had jaw pain immediately after.

My doctor gave me muscle relaxers but when I took them it burned in my muscles and neck and they involuntarily tightened.

I feel dizzy constantly and often vomit from the dizziness. Feels like blood is not going to my brain.

They made me get a second, non-contrast chest CT for the pneumonia and they said no further work up was required.

Can I get a second opinion on the first CT? I’m suffering so much.

There was only an unpleasant physical twinge (and an abstract sense of doom in the back of his mind) before death claimed him.

Wanted to get peoples thoughts on induction strategy during this specific situation. I know tamponade is "fast, full, tight" This is of course different than dissection. When you have both how do you approach it? What other patient factors would you also take into consideration?

Age: 43

Sex: M

Height: 6ft

Weight: not sure but not obese, maybe 20lb over weight

Race: Caucasian

Location:US

Current medications: None

My brother (43, 6ft, maybe 20lbs overweight) suddenly died on Friday and the ME says in was cardiac tamponade and aortic dissection. I’ve read that aortic dissection can cause tamponade but can it go the other way as well?

He began feeling sick on Thursday with vomiting, stomach and back pain. Went to the ER early Friday morning with normal blood pressure and O2. EKG was normal and he coded as they were prepping him for a CT scan and he was saying he couldn’t breathe.

We don’t have any recent medical history as he never made his health a priority, was a heavy smoker and didn’t exercise.

I’m just wondering if this was an acute or gradual thing?

Has anyone ever had one? My aorta isn't that dilated on an echo but on the CT scan I guess they could see a dissection....they want to put me on a beta blocker and do another CT scan in a month but is this generally something they just monitor? Or do you usually need surgery? They didn't really give me any answers over the phone. TIA!

So I remembered this question from an old NBME exam taken during school. If you have a Stanford B type of Dissection, the circulation would cut off from where? I was between Kidney and Lower extremities but I can't seem to find an answer to this question, so I was hoping someone can answer or explain because I didn't know which one to choose and I'm still frustrated over this.

Had my first aortic dissection tonight. Dude had a 100,000$$ BMW and crashed into the wall. Happened to just stumble on the scene while responding to another job. He appeared ok at first. Something about the whole scene just didnt sit right with my partner and I. Vitals were holding alright. Says he was seat belted in, seatbelt wasn't pulled out, no marks on him. Initially told us and PD that he hit the side wall at about 50 MPH. damage to car including both front wheels missing. axle on the ground. about 2-3 feet of intrusion. Driver side back and front all smashed in, unable to open door on driver side. agreed to come to hospital. asked him again how fast because damage to car didnt match speed and he was afraid we were gonna tell cops. turns out they were drag racing and he slammed into the wall at about 120 mph. trauma alerted his ass. see the doctors gathering around ultra sound. We leave to take job and go back to hospital. Kid was in surgery with an aortic dissection. Crazy shit.

Hi all,

So I feel kind of panicky and at a loss. I’ve often suspected I might be a bit Marfan-like due to hand/feet length, body type, scoliosis, hyper flexibility in my hands and wrists, joint pain, teeth crowding, small lower jaw, and severe nearsightedness.

Welp I just did a 23&Me and matched with an unknown 1st cousin who was severely affected by marfans - so that vague worry is now very real!

I’m on medi-cal in the Los Angeles area, and currently don’t have a GP. Would anyone have any idea as to what my next steps are? Just make an appointment with a random GP and be like “hey my cousin almost died from this and I have several of the traits?”.

Thanks so much for reading. Just feeling totally lost!

36F 5’8” 125lbs

My father passed away at age 50 of aneurysm and dissection in aortic arch about 10 years ago and my grandfather also had history. I have SLE.

After my father’s death I had normal echo and a few years later aorta normal on CT done for another reason.

I have a new cardiologist who recommended both an echo and MRA. I had echo last week. The person who did my echo could see arch and said it was normal. What additional information is provided by MRA? I’m concerned about contrast agent gadolinium given my lupus diagnosis and likely need for future tests.

Just to give you worry birds something else to think about. I've been training for my first half-ironman since June - my goal is to race it for my 40th birthday. I'm in pretty good shape but haven't done real distances in awhile so I wanted to start acclimating my body to extended exercise and get my distance biking and running legs back into shape before my "real" training starts in January.

About a month ago I had an episode that I thought was GI related (my 4th one, first occurred back in January, second in March, 3rd in July but none as bad as this one) where I have a stabbing pain in my upper stomach area, vomit and poop uncontrollably for about 8 hours, and then I'm OK about a day later. The first three episodes I recovered in about a day and they were not as bad - doc said it was probably gall related, norovirus, and/or kidney stone. The first two occurrences seemed to be stress related (birth of new son, lots to do) and the last two were workout related (one after a long hard ride and the most recent one after some sprint sets).

This most recent one was different and I went to the ER. The pain was pretty intense and my wife said she had never "seen me that way before." They did a CT scan and said nothing looked wrong, gave me some morphine while I was there (so I was able to stop writhing around) and then sent me home after a few hours. This time it took me 4 days to recover, lots of lethargy and no appetite. I lost 6 lbs - which is a lot for me since I am 6'1" and only weigh 150 on a good day.

My doc suggested I get an ultrasound to check things out more. This ultrasound tech imaged my wife for her two pregnancies and trains other techs on how to do it - she is very good and takes more time than you want to lie there; she's just really into what she does. She found an aortic dissection (thankfully a Type B, otherwise I probably would not be writing this) that was confirmed by my doctor. This is where you develop a tear in the inner lining of your aorta and it begins to separate with higher blood pressure causing more tearing (apparently your aorta is like plywood with many layers). So, the reason for the vomiting was from the pain of the aorta separating more. Needless to say, I haven't done anything training wise over the past few weeks, have been on a low dose aspirin regimen, and was finally able to get an appointment with a cardiologist next week. My guess is I will probably have to get a stent put in, take a few w

Hello smart and kind people!

In management of a suspected aortic dissection, what do you do first: CT angiogram to confirm the diagnosis, or administer beta-blockers immediately to halt progression of the dissection?

Thank you!

Hey gang, cross-posting here from r/askdocs.

32F, 212lbs, 5’9, diagnosed hEDS (but have never been tested for vEDS, although my gma had a brain aneurysm at a young age).

I know that you usually die within a week with aortic dissection but I have connected with people, especially young women for whom there was a low clinical suspicion, who survived and weren’t diagnosed until months or years later after symptoms.

In December of last year I had ripping upper back pain between my shoulder blades and stabbing epigastric pain that came on quite suddenly along with panic attack symptoms that I have never had before in my life. I was also nausous, couldn’t pass gas and could not eat without pain. My HR was 130 I also noticed my aorta was pulsing out of my abdomen.

I went to the ER and they did a chest X-Ray and abdominal ultrasound and found nothing. No gallbladder problems. GI did endoscopy and found nothing — no hiatal hernia. Two months later I went back with chest pain and they found elevated D-dimer, CRP, and pleural effusions and pneumonia which they said was “weird.” But just gave me antibiotics and sent me home.

They also did a chest CT and saw “no evidence of dissection” but they they also said there was motion artifact.

From an article: “Subtle dissections limited to the aortic root and proximal aorta can be dismissed as artefacts. EKG-gated or triggered CT scans reduce motion artefacts and have been shown to improve diagnostic accuracy [10,11], but this imaging modality is not routinely used in all centers.”

I have not gotten better since the antibiotics. But now it feels like whatever was ripping in my upper back has ripped down to my lower back and my ribs are sliding down under my skin. It’s not slipping rib bc when I do the hooking maneuver they do not move. It’s more like an unanchored to the actual muscle/skin feeling (which was not happening for the first 6 months).

My diaphragm does not feel attached in the back and it’s difficult to breathe. I also feel a weird floating membrane in my abdomen.

I also had jaw pain immediately after.

My doctor gave me muscle relaxers but when I took them it burned in my muscles and neck and they involuntarily tightened.

I feel dizzy constantly and often vomit from the dizziness. Feels like blood is not going to my brain. Also extreme panic attack symptoms that I’ve never had before, OCD, confusion and insomnia. They put me on cymbalta for the pain and psych symptoms.

They made me get a sec

Why Kentaro Miura had it? What caused it?