Medical

Controlling Your Blood Pressure

Blood pressure control is very important in patients who have suffered an aortic dissection.  Uncontrolled hypertension can lead to expansion of your aorta, redissection, or rupture.  It is important to consistently take any blood pressure medications you have been prescribed, and to regularly check your blood pressure.  We have created a blood pressure form that you may find helpful for keeping track of your blood pressure. Discuss your blood pressure goals with your doctor, and alert him or her if your measurements are notably high.

Medications

Most dissection patients receive medications to help lower their blood pressure, regardless of how their condition was treated.  This may include beta blockers, calcium channel blockers, Angiotension Receptor Blockers (ARBs), or ACE inhibitors.  It is crucial that you take your blood pressure medications as instructed by your doctor, as this can help prevent additional complications.

If you have a mechanical artificial heart valve, you will need to be on anticoagulation medication (blood thinner) for your lifetime.  Please take care to follow the dosage instructions carefully, as this will prevent blood clots forming due to your valve.

Do not stop taking your medication unless your doctor tells you to.  We have created a medication record form that you may find helpful for keeping track of your medications.

Side Effects

Blood pressure lowering medications may cause light-headedness, or dizziness when rising from lying to standing, or a seated to standing position.  This is called orthostatic hypotension.  If you experience this, discuss your average blood pressures and medication dosages with your caregiver.  Also, up to 20% of patients who take ACEs may develop a dry cough due to the medication.  If this occurs, talk with your doctor about altering your medications.

Follow-Up Visits

Aortic dissection is a chronic condition that requires diligent follow-up with your physician.  Your doctor will monitor your aorta with imaging – usually a Computerized Tomography scan (CT scan) or Magnetic Resonance Angiogram (MRA).  During the first year after your dissection, when your aorta is most vulnerable to change, your doctor will likely image your aorta multiple times,.  After your dissection is stable, imaging will generally be done once per year.  You should also discuss any side effects, new symptoms, or changes in blood pressure with your doctor.

For Surgery Patients

If you have an artificial (prosthetic) heart valve replacement, repair, or prosthetic graft material, you must be protected from infection for the rest of your life.  You need to take an antibiotic prior to certain medical or dental procedures.  This includes dental work, all operations, obstetrical/gynecological, and urological procedures.  We recommend that you do not have any dental work for at least 6 months after surgery unless it is an emergency.

You should contact your physician one week before any medical or dental procedures to obtain the appropriate antibiotic prescription to prevent potential infection if indicated.  If you have any known allergies to medications, inform your physician when you call.

Report any signs or symptoms of infection to your physician immediately.  Do not wait for these symptoms to disappear.  You can have an infection even if you are taking an antibiotic.  The signs and symptoms of infection include:

  • Temperature over 100.5 Fº
  • Chills
  • Night sweats
  • Joint aches
  • Redness
  • Warmth from a wound
  • Drainage containing pus from a wound

If an infection is present, your physician will likely prescribe antibiotics and/or hospitalization.