SOME diseases are only really highlighted when a person comes to harm, because the condition was missed. Aortic dissection is among these.

Issues are caused because not only is the main artery being damaged but also branch vessels may be interrupted, with organs not getting sufficient blood supply.

A type A dissection often presents with sudden onset ten out of ten chest pain, radiating to the back. Often, survivors describe the pain as tearing or ripping in nature.

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Fatality is high, with up to 50 per cent dying immediately, this increasing by one to three per cent every hour. A type A dissection may disrupt the aortic valve, the one-way door which separates the left ventricle from the aorta. Blood flows back into the heart causing heart failure. The coronary arteries come off the aorta just above the aortic valve. If damaged, a heart attack may occur. Blood may also collect between the heart muscle and the pericardium. If this space fills up, the heart will not be able to beat. The aorta may even completely rupture.

A type B dissection may not produce the same dramatic effect as a type A, with some being chronic.

One of the reasons aortic dissections are missed is because sufferers present in so many different ways. As relatively rare disease with just over 2,000 deaths annually in the UK and Ireland, it may not be the first thing a doctor considers. A type A dissection may mimic a heart attack or heart failure. If the head and neck vessels are disrupted it may appear like a stroke. If the blood supply to the intestines suffers, a person may have abdominal pain or bloody diarrhoea. And the list goes on.

Bournemouth Echo:

The gold standard for diagnosis is CT scanning.

Providing the person is fit enough, a type A dissection will be managed by emergency surgery, with every cardiothoracic unit in the country having the capability to attend to this. Type B dissections may initially be managed by lowering the blood pressure to prevent the dissection extending down the aorta. A combination of open surgical techniques and stents, some of which can be inserted through the groin, are available.

The most modifiable risk factors are high blood pressure and smoking.

Bournemouth Echo:

Researchers at the Universities of Dundee and Edinburgh have identified a blood marker desmosine, which can be up to twice as high in those with aortic dissection. More testing will speed up identification, hopefully saving many lives.