It was revealed this week that Depeche Mode keyboardist Andrew “Fletch” Fletcher, died in May from an aortic dissection. Aortic dissections are relatively uncommon compared to other cardiovascular conditions such as heart attacks – but their outcomes are often very poor.
The aorta is the body’s main artery. It carries oxygen and nutrient rich blood from the heart to the rest of the body, providing our tissues with everything they need to function properly. An aortic dissection is a tear of the innermost lining of the aorta. The inner lining, known as the intima or tunica intima, is a single layer of highly specialised cells called endothelial cells, which ensure that the blood stays in its liquid form as it flows around through the body’s blood vessels.
When damage to the endothelial layer occurs, the high-pressure blood tears through the intima layer and into the next layer, the media – literally “dissecting” a pathway into the outer layers of the aorta. If not diagnosed and treated, this can lead to complete failure of the aorta wall and blood escaping out of the vessel and into neighbouring structures and tissues. This stretches the aorta and changes its biomechanical function, which can further contribute to the disease process. As blood is diverted into the tear, it can remove flow from the organs downstream – in some instances completely preventing supply to some of them. The tear also changes the flow of blood through the vessel, which can cause further damage to the specialised endothelial lining cells.
