ER star Deezer D to undergo heart surgery

Rap star turned actor, Deezer D, is best known for his years of playing nurse Malik McGrath on ER. He is about to face his own hospital experience. Plagued by recurrent episodes of pneumonia and heart failure over the last year, Deezer D was finally diagnosed with aortic dissection, caused by an abnormal aortic valve. He is going to have his aorta repaired and aortic valve replaced. (For more information about aortic valve replacement see: Robin Williams and Barbara Bush both undergo heart valve surgery) Aortic dissection is the same disease that killed actor John Ritter in 2003.

The aorta is the main blood vessel that takes blood from the heart to the rest of the body. Like all blood vessels, its walls are made up of three layers:

  • the inner lining (which is in contact with the blood) called the tunica intima (commonly called the intima), which is made up of endothelial cells- thin smooth cell which reduce friction through the blood vessels.
  • the tunica media which is made up of smooth muscles and elastic tissues
  • the tunica adventia, the outer layer of the blood vessel made of a more fibrous material.

Blood dissecting from the tunica intima to the tunica media

In aortic dissection, damage to the intima layer allows blood to dissect its way into the media layer. Over time, the wall of the blood vessel balloons out. This weakens the wall of the aorta, and if it reaches a critical point, the wall can rupture, leading to sudden death. The dissection can occur anywhere along the length of the aortic, either close to the heart (proximal dissection) or lower down in the abdomen (distal dissection). Aortic dissection occurs more frequently in men, and between the ages of 50-55 for proximal dissection, 60-70 years old for distal dissection. Factors that can increase the risk of aortic dissection include high blood pressure, an abnormal aortic heart valve (especially one called a bicupsid valve where the valve is made of two instead of the normal three leaflets), family history of aortic dissection, and certain genetic conditions, such as Marfan’s Disease and Turner’s Syndrome.

Aortic dissection is usually asymptomatic in its early stages, but as the dissection progresses, symptoms may include chest pain, shortness of breath, weakness, stroke. The diagnosis is made with x-rays or heart ultrasound. If the dissection is small, it may be watched and any underlying conditions, such as high blood pressure, treated medically. If the area of dissection is larger, or increasing in size, surgery is needed. Surgeons remove as much of the dissected aorta as possible and repair the aorta with a metal or plastic tube called a graft.

Symptoms of rupture include sudden chest pain, often described as severe and tearing, cold sweats, and difficulty breathing. This is a medical emergency, as the mortality rate is 80%, with 50% dying before they even reach a hospital.

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Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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