Question

In aortic dissection (uneven BP), aortic dissection will damage first which arteries?

Answer 1

An aortic dissection typically damages the arteries closest to the heart first, which includes the coronary arteries as they branch off from the ascending aorta.

Step-by-step explanation:

In the event of an aortic dissection, the damage will often affect the arteries closest to the heart first. There are several important branches of the aorta that can be involved in an aortic dissection. The first part of the aorta is called the ascending aorta, and it gives rise to the coronary arteries, which supply blood to the heart muscle itself. An aortic dissection in this region can compromise coronary circulation. As the aorta curves to form the aortic arch, three major branches emerge: the brachiocephalic artery, the left common carotid artery, and the left subclavian artery. A dissection here can potentially affect blood flow to the upper body and brain. Further down, as the aorta enters the abdominal region, it is known as the abdominal aorta and gives rise to several other vital arteries such as the celiac trunk, mesenteric arteries, and ultimately divides into the common iliac arteries. An aortic dissection in the abdominal aorta can damage these branches, impacting blood supply to organs such as the liver, spleen, stomach, and intestines.

Answer 2

The major branches off the aortic arch, specifically the brachiocephalic artery, the left common carotid artery, and the left subclavian artery, are most susceptible to damage first during an aortic dissection. The coronary arteries can also be affected if the dissection is near the root of the ascending aorta.

Step-by-step explanation:

In aortic dissection, the condition occurs when there is a tear in the inner layer of the aorta, leading to blood flowing between the layers of the wall of the aorta and forcing the layers apart. The aortic arch gives rise to three major branching arteries: the brachiocephalic artery, the left common carotid artery, and the left subclavian artery.

These vessels are particularly susceptible to being damaged first during an aortic dissection due to their proximity to the heart and their classification as elastic arteries, which are the types of arteries that can expand when the blood pressure is high. As the ascending aorta gives rise to the right and left coronary arteries, an aortic dissection occurring near its root could also potentially affect these arteries that supply the heart muscle itself.