YOUR HEALTH

DEAR DR. DONOHUE: My grandfather, 76, just died of an aortic dissection. It happened very quickly, and he barely made it to the hospital; he died shortly after. Our family isn't too clear on what happened, and if this is hereditary. Should all of us be checked for it? -K.D.

ANSWER: The aorta, the body's largest artery, is welded to the heart and receives all the blood the heart pumps with each beat. The aorta runs from the heart to the bottom of the abdomen, where it divides into two arteries for the legs. Its many branches supply the entire body with blood.

An aortic dissection is a tear in the aorta's wall, often in its first part, the

part in approximation to the heart. The inner lining of the artery separates from the wall. Blood under high pressure from just being pumped seeps into the space opened up by the tear and peels more of the lining away from its wall.

Extreme chest pain -worse than the pain of a heart attack -is the salient symptom of a dissection. This is a true emergency, and even with great care and prompt attention, death often results.

One emergency treatment is lowering blood pressure to stop further dissection of the aortic lining away from its attachment to the aortic wall. Most dissections require surgical repair. The cause of aortic

dissection is often high blood pressure. In only a few cases is aortic dissection the result of an inherited disorder, and for those few cases, other signs of the inherited disorder are readily recognized. If your grandfather had one of these rare inherited problems, the doctors would have told your family. They did not. Your family does not need to be checked for aortic dissection.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853-6475.