What caused the Depeche Mode keyboardist's death?

We learned this week that Andrew Fletcher, Depeche Mode's keyboard player, died in May from an aortic rupture. Although aortic dissections tend to be less common than other cardiovascular diseases like heart attacks, they can have very serious consequences.

The main artery in the body is the aorta. It transports oxygen- and nutrients-rich blood from heart to rest of body. This provides our tissues with all they need to function well. Aortic dissection refers to a tear in an innermost layer of the aorta. Endothelial cells are a single layer of highly skilled cells that enclose the inner lining. They ensure that blood stays in liquid form throughout its journey through the blood vessels.

High-pressure blood flows through the endothelial layers to cause damage. The next layer is the medial layer. This literally cuts a path to the outer layers.

This can cause the complete collapse of the aortic walls and blood leaking into nearby structures and tissues if it is not treated. This can stretch the aorta, alter its biomechanical function and contribute to the disease process.

The tear can cause blood to divert towards the tear, which may in some cases prevent the flow of some organs below. The tear can also alter blood flow through the vessel which may cause additional damage to the endothelial cells.

About three to four people in 100,000 suffer from aortic dissections. They are twice as common in ascending than descending aortic dissections.

Knowing the exact location of an aortic dissection is crucial as it can impact the severity of the condition, treatment, and survival chances. Type A dissections involve the ascending orta, while type B are those that involve the descending aorta.

Gender can also influence the type and likelihood of aortic dissection. Aortic dissection is more common in men than it is for women. It usually happens around the age 60 in the case of men. Type A dissections occur twice as often in men than in women.

Aortic dissections can be attributed to two factors: lifestyle and genetic conditions. These have an impact on the heart and blood vessels. Poor diet and smoking can lead you to hypertension, which is a high blood pressure. This increases the risk that the blood vessels' specialized cells will be damaged. It is more likely that someone will have an aortic dissection.

Cocaine use is another important lifestyle factor that can increase the likelihood of developing aortic dissection. You will experience an increase in heart rate and blood pressure. It also decreases the blood flow through your arteries, which supply your heart.

Cocaine can make a person more prone to aortic dissection later on in life.

A number of genetic disorders can also increase the risk of aortic disection. Marfan syndrome is the most common, affecting approximately one in every 5,000 people. This condition prevents the body from making enough of a key protein, which is responsible for blood vessel walls' structure and elasticity.

The walls of blood vessels can become weaker if they don't have enough of this protein. They are also more at risk of rupture or dissection. Marfan syndrome patients are more likely to experience aortic dissection in younger ages, typically around 38.

Dissection can also be caused by trauma, and traffic accidents are the most common cause. They can lead to a dissection or spontaneous rupture of your aorta.

Aortic dissection is characterized by pain. This can be described as a tear in your abdomen, chest, or back. Predisposing conditions are treated with medication such as antihypertensives and beta-blockers, which lower blood pressure, and decrease the chance of endothelial damage. This treatment is not appropriate for type A dissections. Type A dissections almost always require immediate surgical intervention.

It is important to recognize aortic dissection early in the life of anyone with a suspicion or who knows about it. The first phase of treatment involves surgical repair or replacement. The results of this procedure can be mixed as the survival rate for type A dissections is typically between 52-94% and 45-88% five years later. Type B has similar survival rates at one year (about 56-92%) and five years (48-82%).

Antihypertensive medication can sometimes be used in type B dissections to stabilize the patient prior to surgery. However, this is not always possible. Dissections are a serious condition that cannot be treated.

Aortic dissection can have serious consequences and potentially poor outcomes. It is important to change lifestyle factors such as exercise, healthy eating habits, and quitting smoking to reduce your risk. You should also ensure that any other health conditions, such as high blood pressure, are being monitored.

This article was published in "The Conversation".