林赛・格雷厄姆参议员家属于周末对外公布，这位 71 岁政界人士因 “突发急症” 去世。
周日，华盛顿特区法医公布初步鉴定结果：该参议员死于动脉粥样硬化性心血管疾病引发的主动脉夹层。
美国血管外科学会介绍：主动脉夹层属于危及生命的急症。主动脉是人体最主要的大动脉，接收心脏泵出的血液并输送至全身;主动脉内壁出现裂口时，就会引发主动脉夹层。
内壁裂口会使血液涌入主动脉血管壁各层之间，造成身体各个器官供血不足。
托马斯杰斐逊大学血管外科助理教授罗伯托・阿鲁博士接受美国广播公司采访时表示： “主动脉夹层属于致命急症，需要快速确诊，部分患者必须立刻实施急诊手术。后续治疗方案，取决于主动脉撕裂位置，以及是否出现器官供血障碍等并发症。”
倘若涌入血管壁夹层内的血液冲破主动脉外层血管壁，病情会迅速恶化，直接致人死亡。
主动脉夹层症状通常骤然发作，典型表现为剧烈胸痛或背痛，痛感和心梗十分相似。
阿鲁博士称，患者常会描述 “一生中经历过最剧烈的胸痛或背痛，感觉像是撕裂、刀割一样”。
“任何人出现上述症状，或是类似心脏病发作的不适感，都必须马上前往急诊就诊。及时确诊与急救是保住生命、改善预后的关键，直接决定生死。”
美国血管外科学会列出其他伴随症状：剧烈腹痛、晕厥、呼吸困难、腿部疼痛或无力、行走困难，以及类似中风的症状，例如突发视力丧失、言语障碍、肢体乏力。
阿鲁介绍，治疗方案需根据夹层位置与并发症判断，部分患者需要紧急手术。
主动脉夹层分为两类： A 型夹层更为多见，病情通常更危重，撕裂位置靠近心脏，即升主动脉区域; B 型夹层，撕裂发生在主动脉下段，也就是胸降主动脉。
阿鲁表示，无并发症的 B 型主动脉夹层可以先用药物控制血压、心率，但依旧需要严密监测，短期或远期仍有可能需要接受手术。
主动脉夹层整体发病率不算高，但高发人群为 60 至 70 岁男性。高血压患者、吸烟者患病风险更高，患有遗传性结缔组织疾病的人群同样属于高危群体;外伤也有可能诱发该病。
美国疾控中心数据显示，2019 年全美大约有 1 万人死于主动脉夹层或主动脉瘤(主动脉局部像气球一样膨出扩张)。
通过控制血压、远离烟草，能够降低主动脉夹层发病风险，起到预防作用。
本文作者杰德・科本医学博士、公共卫生硕士，执业医师，拥有儿科与全科预防医学专科资质，为美国广播公司医疗撰稿团队成员;尤里・贝纳贾乌德参与本次报道。
What to know about aortic dissections after death of Sen. Lindsey Graham
Senator Lindsey Graham’s family announced over the weekend that the 71-year-oldlawmaker diedfrom “a brief and sudden illness."
On Sunday, preliminary findings from the Medical Examiner of the District of Columbia said the senator died from an “aortic dissection due to arteriosclerotic cardiovascular disease."
An aorticdissection is a life-threatening medical emergency that results from a tear in the inner layer of the aorta, the body’s main artery that receives blood from the heart and delivers it to the body,according to the Society of Vascular Surgery.
This tear allowsblood to flow betweenlayers of the aorta and can prevent adequate blood flow from reaching organs in thebody.
“An aortic dissection is a life-threatening condition that requires rapid diagnosis, as emergent surgery can be necessary. Subsequent decision-making is based on the location of the tear in the aorta and any associated poor blood flow to organs," Dr. Roberto Aru, an assistant professor of vascular surgery at Thomas Jefferson University, told ABC News.
This problem can quickly become deadly if the blood flowing in the dissected layers of the aorta ruptures through the outer layer of the aorta.
Symptoms of an aortic dissection often occur suddenly and include severechest or back pain that resembles a heart attack.
Aru said patients often present with “the worst chest or back pain of their life that is similar to a ripping or stabbing sensation”.
“Anyone experiencing these symptoms or any symptom resembling a heart attack should seek emergency medical care,” Aru said. “A timely diagnosis and emergency medical care are paramount for survival and improved outcomes, so it can mean the difference between life or death."
Additional symptoms can include severe abdominal pain, fainting, shortness of breath, leg pain or weakness, difficulty walking, and stroke-like symptoms such as sudden loss of vision, speech difficulty or weakness, according to the Society of Vascular Surgery.
Treatment can require emergent surgery, depending on where in the aorta the dissection is located and what complications are associated with it, Aru said.
There are two types of aortic dissections. Type A dissections are more common and more often severe, involving a tear in the aorta near the heart, called the ascending aorta. Type B dissections occur from a tear in the lower portion of the aorta, known as the descending thoracic aorta.
Aru said type B aortic dissections without complications may be managed with medications to lower a person’s blood pressure and heart rate but still require close monitoring and may eventually need surgery in the short or long-term.
While rare, aortic dissections are more common among men in their 60s and 70s. People who smoke and those with high blood pressure are at increased risk, in addition to those with genetic connective tissue disorders. It can also be caused by trauma.
About 10,000 people died in 2019 from an aortic dissection or aortic aneurysm, a balloon-like bulge in the aorta,according to the Centers for Disease Control and Prevention.
People can lower their risk or prevent an aortic dissection from happening by managing their blood pressure and avoiding smoking.
Jade A. Cobern, MD, MPH, is a practicing physician, board-certified in pediatrics and general preventive medicine, and is a fellow of the ABC News Medical Unit. Youri Benadjaoud also contributed to this reporting.
