Alan Thicke was playing ice hockey with his son Carter on Dec. 13 when he collapsed and later died.
The 69-year-old Canadian actor’s death certificate said his aorta ruptured about three hours after it developed a tear. An aortic tear also killed actor John Ritter in 2003.
Here’s what you need to know about what happened to Thicke and his heart health:
The aorta is the main artery that carries blood to your heart, brain, arms and the rest of your body. It’s shaped like a candy cane, according to Dr. Maral Ouzounian, a cardiac surgeon at the University Health Network’s Peter Munk Cardiac Centre in Toronto. According to Thicke’s death certificate, he experienced a Type A dissection on his aorta.
A dissection means there was a tear in the wall of the aorta and blood ends up in two channels instead of one. A Type A dissection means the rip occurred in the first part of the aorta, closest to the heart, she explained.
“Those types of dissections are uniformly fatal without immediate open cardiac surgery,” Ouzounian told Global News. Ouzounian is a cardiac surgeon specializing in complex aortic repair. She looks after patients with aortic aneurysms and researches genetic causes of them.
“When dissection happens, there is often, but not always, a tremendous amount of pain,” she said.
What causes a torn aorta?
Tears usually happen if the aortic wall is fragile. That could be tied to pre-existing issues, such as an aortic aneurysm, which is when the aorta becomes enlarged. Sometimes doctors can pick up on the aneurysm and monitor its growth while controlling blood pressure levels.
Once it gets to a certain size, doctors repair the aorta through an elective surgery. If it’s not picked up, the walls expand and weaken, leaving you vulnerable to a tear or rupture.
People with high blood pressure can tear their aorta if they have severe hypertension, while dissections can occur – in rare cases – from doing extremely strenuous weight lifting or from extreme emotional or physical exertion.
What is the survival rate for ruptured aortas?
If people with a Type A dissection don’t get surgery, the death rate is one per cent per hour.
“Within 48 hours, 50 per cent of people who have this will die,” Ouzounian said.
Elective surgeries are incredibly successful: if doctors monitor an aneurysm and its growth and repair the aorta when necessary, death from the operation or its complications is less than one per cent.
If a dissection occurs, such as in Thicke’s case, “you may die before you even get to the hospital for emergency surgery,” Ouzounian said.
There’s a 20 per cent risk of death from surgery, and a much higher risk of complications or future problems following emergency surgery as well.
Reports suggest Thicke made it to hospital and the emergency room but that he ultimately died while in the operating room.
Operating on a ruptured aorta is an hours-long surgery – up to eight hours. The patient is connected to a heart lung machine, their body is cooled to reduce blood flow to the brain and the rest of the aorta is replaced with a graft and stitched back together.
What are the symptoms to pay attention to? Why is it often confused with a heart attack?
Media outlets report that Thicke felt chest pains while he was playing ice hockey with his son. He felt nauseous, was vomiting and ultimately ended up in hospital where he died, according to TMZ.
These are common heart attack symptoms too, according to Ouzounian. People often confuse a ruptured aorta with a heart attack.
Most patients with a ruptured aorta have severe chest pain, they describe a tearing or ripping pain in between their chest and shoulder blades.
But a ruptured aorta is only detected through a CT scan to confirm a diagnosis. If it’s obvious, the patient is rushed to surgery.
People who have encountered an aortic aneurysm should have their family – siblings, children and parents – screened with imaging for the same condition.
Aneurysms are asymptomatic so 95 per cent of the time people don’t even know if they’ve had one. Ritter’s family, for example, learned that he had a type of thoracic aneurysm that ran in his family. His loved ones checked their health after his death and learned several members of his family had aneurysms too, Ouzounian said.
Patients with a history of high blood pressure also need to be watched closely.