Silent danger When the back pain started, 31-year-old Ty Vongnakhone first tried ointment and then a massage. Still, the pain was getting worse, so the Burnaby resident went to his local hospital. There, a stunning diagnosis – an extensive type B aortic dissection. Soon, he was rushed to Royal Columbian Hospital, where he would spend the next five weeks under the care of a medical team that spanned multiple departments. “You know, blood pressure is like a silent killer if you’re not really watching it,” Ty remarks almost three years later. “I didn’t really watch my blood pressure.” Type B dissection involves a tear in the descending part of the aorta, which is the main artery that carries blood away from the heart to the rest of the body. While dissections are not a common injury, high blood pressure is a main cause, explains Dr. Matt Bernard, a Royal Columbian internal medicine specialist. “You can imagine, you have this arching aorta, blood is coming up out of the heart, it’s hitting this curve, it’s being forced around the curve of the aorta, and over time that is going to have a certain amount of stress on the wall of the aorta, and it could cause a tear,” says Dr. Bernard. “So high blood pressure is a strong
risk factor.” The first treatment for Type B dissections is usually not with surgery, but rather through aggressive blood pressure and heart rate control to allow the tear to begin to heal itself. As Ty started to undergo this medical treatment, he faced another major threat – his kidneys were failing. Dr. Bernard says an aortic dissection can reduce the blood flow to organs like the kidneys, putting them at danger of acute injury. “You might hope the person has enough kidney reserve that even if there is an initial insult to the kidneys that requires that person to go on dialysis, with time, as the kidneys recover from this injury, there is enough blood flow and enough kidney reserve to get a person back off dialysis, but that may not be the case,” says Dr. Bernard. Ty had the aortic tear surgically treated with a graft to prevent a worsening of the dissection. “This hospital saved my life,” says Ty, who later received a kidney transplant in Vancouver. “I am so thankful and grateful for all the doctors and nurses that came together to help me, revive me, and get me back to where I am today.”
Young man with high blood pressure suffers aortic dissection
ROYAL COLUMBIAN HOSPITAL FOUNDATION I YOUR HEALTH MATTERS
13
