The lucky “snore-rock” player The cheerful laughter of Brother Liu rang out again in the ward. Brother Liu is 55 years old, fat and claims to be a “snore-rock” player. Why does he call himself a “snore rocker”? That’s because Brother Liu’s earth-shaking snoring is as powerful as heavy metal rock music, which not only “kills” others, but also deeply hurts Brother Liu’s own health. Brother Liu was admitted to the hospital in the early morning a few days ago, when he was pale and dripping with sweat and had fallen into a coma, his situation was very critical. When we asked his family, we learned that he had sudden onset of severe chest and back pain during sleep (one of the manifestations of aortic “tearing”, which was diagnosed as aortic coarctation by CT angiography), and when we asked him about his sleeping condition, we learned that he was snoring very badly (he had been diagnosed with obstructive sleep apnea syndrome, which was not treated). Thankfully, after an intense emergency surgery, Brother Liu was finally released from life-threatening conditions. In the follow-up treatment for Brother Liu, there was a very important item in the medical prescription: treat snoring. But why was Brother Liu asked to treat snoring? What is the relationship between snoring and aortic “tear”? The formation process of “snoring rock music” and the danger Snoring is commonly known as snoring, not all snoring is a disease, but long-term and regular snoring is a pathological phenomenon, indicating that the snorer has narrowed upper airway and may suffer from or will develop into obstructive sleep apnea syndrome (OSAHS). The “snoring rock music” refers to the snoring sound of OSAHS patients, because their upper airway collapses and obstructs during sleep, causing apnea and hypoventilation, and the snoring sound occurs during inspiration, is very loud (louder than 60 decibels or can be heard in the room), intermittent, high and low, and tends to be quiet after a few sounds. The basic rule is that snoring – airflow stop – gasping – snoring alternately, which constitutes the “snoring rock music”. Patients have a continuous “rock and roll accent” during the whole night sleep, and even snore loudly during meetings and car rides. Obstructive sleep apnea syndrome is defined as a syndrome characterized by severe snoring during sleep, recurrent apnea, and daytime sleepiness. Sleep apnea is defined as having more than 30 recurrent episodes of apnea and hypoventilation during 7 hours of sleep per night, or an apnea hypoventilation index (AHI) ≥ 5. The primary diagnostic tool is polysomnography monitoring. Obstructive sleep apnea syndrome is very dangerous for patients’ health, including causing hypertension, coronary artery disease, various severe arrhythmias, congestive heart failure, stroke and other cardiovascular diseases; chronic pharyngitis, pulmonary hypertension; aggravating the existing diabetes; and the most dangerous one is the disease that may cause sudden death of patients – aortic coarctation (commonly known as -Aortic coarctation (commonly known as aortic “tear”). Aortic “tear” fatal “secret” Brother Liu, as a senior “snoring rock” player (severe obstructive sleep apnea syndrome patients), his aorta occurred What is the secret of the “tear” in his critical life? The human aorta is the main channel for transporting blood, and the normal wall of the tube consists of three closely fitting layers: the inner membrane, the middle membrane and the outer membrane. The aortic “tear” is medically known as aortic coarctation, which is caused by various reasons that the endothelium of the aortic vessel wall is torn, and the arterial blood flows through this fissure into the cystic degeneration of the intima, and the endothelium is gradually peeled off and expanded to form two lumens in the artery (the true lumen is the original channel for transporting blood, and the false lumen is the new lumen formed by the peeled off endothelium In the false lumen, blood can only flow in but not out normally, which makes the false lumen like a balloon, getting bigger and bigger, eventually leading to aortic rupture, and the patient is likely to die in an instant. Aortic coarctation is so devastating that it is called a “catastrophic critical emergency” of cardiovascular disease. Brother Liu was extremely lucky, while American volleyball player Hyman, Chinese volleyball player Zhu Gang, and famous violinist Paganini all died of sudden aortic “tears”. If patients with acute aortic coarctation are not treated in time, more than 1/4 of them die within 24h, more than 1/2 die within a week, more than 3/4 die within a month, and more than 90% die within a year. The “intimate relationship” between “snoring rock music” and aortic “tear” “Snoring rock music” not only affects other people’s rest, but also makes the aorta “torn”. It is true that it can also make Liu’s aorta tear. Several studies have confirmed the intimate relationship between “snore rock” and aortic “tear” (aortic coarctation). Severe obstructive sleep apnea syndrome patient), long-term hypoxemia and hypercarbia, which caused a series of self-reactions, as if igniting the “fuse” of many diseases – neuro-endocrine regulation changes, resulting in hypertension and other multi-system diseases, and chronic systemic hypertension is the first recognized aortic Chronic systemic hypertension is the first recognized susceptibility factor for aortic coarctation. Secondly, the obstructed airways of the “snore rock” players are like a pair of big hands covering the mouth and nose when they inhale, and the harder they inhale, the lower the intrathoracic pressure is, and the intrathoracic pressure can be as low as 20 times of normal (the intrathoracic pressure is like a pumping machine pumping the aortic vessel wall, and the lower the intrathoracic pressure is, the stronger the pumping effect is, and the more the aortic vessel wall is stretched and enlarged). The lower the intrathoracic pressure, the stronger the suction and the greater the distension and enlargement of the aortic wall), and the suction of the aortic wall by a lower than normal intrathoracic pressure may also contribute to the development of aortic coarctation. Finally, the significant increase in arterial transmural pressure (transmural pressure equals the difference between blood pressure and intrathoracic pressure) during each “interval” (apnea) may also contribute to aortic coarctation. In conclusion, the intimate relationship between “snore rock” and aortic “tears” has been proven by several studies, and how “snore rock” players should get rid of them. How can snore rockers escape the deadly threat of aortic tear? ”First, treat obstructive sleep apnea syndrome aggressively. It includes weight control, exercise, quit smoking and alcohol and other bad habits, stop or reduce the use of sedative drugs, and keep sleeping in the lateral position; device treatment to artificially increase the ventilation volume, increase the patient’s oxygen intake, and relieve the symptoms of oxygen deficiency; surgical treatment to restore the normal airway ventilation by eliminating the airway obstruction and collapse. Secondly, “snore rock” players should have regular medical checkups for early detection of aortic lesions. Clinical studies have confirmed that more than 10% of patients with obstructive sleep apnea syndrome have aortic “tears”. Finally, as soon as aortic coarctation is detected, seek aggressive treatment in the hospital. The main options include medical, interventional and surgical treatment. Among them, interventional treatment techniques have been widely used in clinical practice, which have the advantages of high success rate, low injury and low complication rate. Special attention should be paid to regular follow-up and blood pressure and heart rate control in patients with aortic coarctation, whether surgical treatment or endoluminal interventional repair, is crucial. It is very helpful to improve the prognosis and prolong the survival time. Although Brother Liu, the “snoring rock music” player, was eventually released from life-threatening condition after doctors’ unremitting efforts, who knows how many patients with obstructive sleep apnea syndrome eventually die due to aortic “tear”? Therefore, patients must take active action to prevent sudden death from aortic “tearing” by following the methods to get rid of the aortic “tearing”.