How painful is “tear-like pain”? Yesterday morning, lying in the Zhejiang Provincial People’s Hospital cardiothoracic surgery bed 17 of Mr. Huang described: “very painful, a kind of indescribable pain. If you really want to compare, it is like the whole person was split a knife, and then slowly tear the feeling.” 11 days ago, Mr. Huang was diagnosed with acute aortic coarctation, a disease with a mortality rate of 50% within 48 hours, clinically known as the “whirlwind killer”. In the provincial people’s hospital cardiothoracic surgery and other multidisciplinary collaboration, he was out of life-threatening. Suffered from hypertension for seven or eight years fishing back sudden onset of chest pain Mr. Huang, 47 years old, Zhuji, 172 cm tall, weighing 165 pounds, is the boss of private enterprises, suffering from hypertension, hyperlipidemia for seven or eight years, love to eat fatty meat, especially love pancetta; like to drink a little wine, the night before the onset of half a kilogram of yellow wine; do not like exercise, after dinner, sitting in front of the computer is not moving. October 17, 11:00 pm, Mr. Huang and his wife back from fishing, just to the door, did not have time to get off, he felt an inexplicable pain in the chest. “It really hurts, chest pain after back pain.” His wife helped him into the house, told him to lie down and gave him a chest rub. At that time, they thought lying down and resting for a while would be better, but two hours later, Mr. Huang’s chest pain did not ease, but also began to sweat cold. “At that time, I really had a feeling of going to the end.” Mr. Huang said. His wife rushed him to the hospital, and a comment from the nurse on duty scared her enough. “That nurse said, the pulse is gone, how come it just came?” The test results surprised her even more. Although she had never heard of acute aortic coarctation, she understood the horror of the disease once she heard that a blood vessel in her husband’s heart had torn, a disease from which the former U.S. women’s volleyball star Hyman died. After a clear diagnosis, the doctor recommended that Mr. Huang be transferred to the hospital immediately, considering that he had undergone radiotherapy treatment for lymphoma, a year ago. At 12:00 that night, he was transferred to Zhejiang Provincial People’s Hospital. The aortic tear was sixty to seventy centimeters and had involved the kidney. ”Generally speaking, once acute aortic coarctation occurs, it means that life enters the countdown and the risk of death will increase by 1% with each passing hour, and the two-week survival rate is only 20%.” Cui Yong, deputy director of cardiothoracic surgery at the Provincial People’s Hospital, said that an emergency chest opening and replacement of the torn vessel was the only way to save the patient. The surgery is very risky, with an intraoperative mortality rate of 20 percent, the largest surgery the body can endure. Dr. Cui had worked in Canada and had done many units of acute aortic coarctation surgery, but Mr. Huang’s case also made him feel a little tricky. “When he came in, the aorta from his heart to near his thigh had torn, about 60 to 70 centimeters long, and it had involved his kidneys, his consciousness was fuzzy, his blood pressure was low, and with last year’s radiotherapy treatment, his physical condition was not optimistic and the risk of surgery was very high.” Dr. Cui said. ”Although surgery is risky, but at least there is hope, better than waiting for death.” Mr. Huang’s wife said she decided to operate. With the cooperation of the relevant departments, Dr. Cui operated on Mr. Huang. The first step is to turn off the main gate of the water pipe to stop the flow of water. The blood in the human body is circulating every second, how to “turn off”? Dr. Cui used a technique called “deep hypothermia stop circulation”, that is, in the state of extracorporeal circulation, the patient’s body temperature down to 25 degrees Celsius, let the blood stop circulation. During this time, the doctor had half an hour to replace the torn blood vessel with an artificial vessel, more than half an hour, the patient’s organ function will be damaged. The surgery took more than six hours and Dr. Cui used nearly 100 fine sutures. Patients with hypertension should have their blood pressure monitored every morning and evening. Be alert to the presence of chest pain The incidence of acute aortic coarctation is not high, about 7-8/100,000, mostly seen in middle-aged and elderly people aged 45-70. In addition to congenital aortic defects, hypertension is a common risk factor for the disease, especially in patients with poorly controlled blood pressure. Cui Yong said that almost all of the patients he sees with acute aortic coarctation have a history of hypertension. ”The human blood vessel wall has three layers, and a sudden rise in blood pressure will produce tremendous pressure on the vessel wall, and when it is difficult for the vessel to withstand this pressure, the vessel wall will then be torn to appear as a sandwich, and blood gushes in. Once the blood vessel ruptures, it is easy to die suddenly.” Dr. Cui said. Dr. Cui also found that every year when the weather turns cold, the number of patients with acute myocardial infarction and acute aortic coarct increases, which is related to blood pressure fluctuations. He reminded that patients with hypertension must monitor their blood pressure every morning and evening, if they have not done 24-hour ambulatory blood pressure monitoring, it is best to do one; if there is unexplained chest pain, to promptly seek medical advice; hypertensive patients should also adhere to a low-fat and low-salt diet, quit smoking and limit alcohol, appropriate exercise, bad habits are prone to induce blood pressure fluctuations.