Aortic aneurysm stratifying - an anguish of an internal environment of the aorta, accompanied stratification of a vascular wall by a blood.

Pathogenesis. In an initial stage of stratifying of an aortic aneurysm there is an anguish internal, and sometimes and its average environment at conservation of integrity of an external environment of an aorta. In the further the blood getting under greater pressure stratifies all wall of an aorta and breaks through an external environment that conducts to instant mors of the patient from the most massive internal bleeding. In other cases stratifying extends more often in distal, less often - in a proximal direction that leads to a hemopericardium, an abruption of the aortal valve, a serious aortal failure, an occlusion of coronary arteries. Stratifying can come to the end with repeated break of an internal environment of an aorta below a place of initial stratifying, however such safe cases of self-healing are extremely rare.

Signs, current. Disease begins was acutely, rate of development rough. The basic sign - the most severe stethalgia, more often tearing apart or cutting character. The pain can be localized in the left half of thorax or in interscapular space, irradiates in a back and quite often extends in an anticardium. The patient is raised, does not find to itself a place from a pain. After the first attack there can come the short-term simplification replaced then new attack of former pains. Alternating of painful attacks and light intervals is bound by that stratification of a wall of an aorta occurs sometimes in some stages. Besides involving of new sites of a wall of an aorta in process of stratification can change a place of the greatest expression of a pain, migration hurt from a place of an initial anguish of an aorta on a course of stratifying - a characteristic attribute of this pathology. After an initial attack of a stethalgia in the further it can mainly be localized in a stomach, a loin that it is necessary to consider at diagnostics. Quite often at once after a pain the picture of a serious collapse with falling arterial pressure, thready pulse, peripheric displays of a vascular failure develops; to deduce the patient from a collapse almost never it is possible. In other cases the first painful attack is accompanied by sharp rising of arterial pressure. Owing to disturbance of a blood flow in arteries departing from an aorta probably occurrence of appreciable asymmetry of pressure on the right and left arms (the ischemia of extremities sometimes does impossible definition of arterial pressure on one or both arms), signs of disturbance of a cerebral circulation (parapareses, paraplegias), a myocardial infarction, are frequent episodes of a loss of consciousness. Involving in process of an abdominal aorta is usually accompanied by disturbance of a circulation in pool of the basic mesenteric vessels with connection of a picture of a serious intestinal obstruction. At proximal stratifying more than in half of cases the aortal failure is taped. At break stratifying aneurysms in a cavity of a pericardium the cardiac tamponade is possible, break of an aorta in the left pleural cavity is possible also. From the moment of an initial anguish of an internal environment before final break of an external environment and mors of the patient passes from several minutes about several day during which sometimes there come the short periods of relative well-being. Depending on prescription of development of disease distinguish acute (till 2 weeks) and chronic (more than 2 weeks), stratifying of an aorta.