Friday, March 8, 2013

Chris Fox
Brisbane, Australia 

Chris experienced a  life-threatening ascending aortic dissection
due to Bicuspid Aortic Valve Disease on August 3, 2004.

At the age of 30, Chris Fox led a full and physically active life. If not at the gym, he could often be found scuba diving or participating in martial arts during his leisure hours. He had no reason to think that he would find himself in a desperate, life-threatening emergency. He did not know that he was born with bicuspid aortic valve disease and that inside his chest his ascending aorta had ballooned to 5.3 cm. 

Chris, back right, and his family
That Tuesday in early August had been an ordinary sort of day for Chris, who lives in Brisbane, Australia. But while traveling home after work, he realized that suddenly something was very wrong. Following is Chris' description of what happened.

"On the 03/08/04 I was on my way home from work on the train when I got a sharp stabbing pain in the centre of my chest / base of my sternum, which radiated to my jaw / base of my ears.  At this point I started to feel very light-headed and thought I may pass out (I still have no idea how I remained conscious after now knowing what that pain was.)  I got off at my stop and walked the 300/400 meters home where I sat down for 5 minutes to try and collect my thoughts.  After deciding that something definitely wasn't 'right' (a decision I now know actually saved my life), I jumped in my car and drove myself to the local Medical Centre, asked to see the doctor, sat down and patiently waited for my name to be called.  The doctor took one look at me, put me on an ECG machine and called an ambulance.  They then took me to Royal Brisbane Hospital Emergency Department, arriving about 6pm. The next 12 hours were spent being examined by a multitude of doctors, blood tests, x-rays and then the CT scan, which showed the 'Aortic Dissection'."

When the ascending aorta in the chest tears, it is always a surgical emergency and time becomes critical. Something over 12 hours had already passed since Chris felt that first stabbing pain in his chest, and now he needed to be transported to a facility equipped to perform aortic surgery. He remembers being taken to The Prince Charles Hospital. Here echocardiography revealed a leaking bicuspid aortic valve along with the aortic dissection, and it was confirmed he needed emergency surgery. Beginning about 7:30 AM on August 4th, in a procedure lasting just over 6.5 hours, Chris' aortic valve, aortic root, and ascending aorta up to the arch were all replaced. For 26 minutes, deep hypothermic circulatory arrest was used.

Post-operative bleeding was controlled without again returning to surgery, and Chris awoke in intensive care the next morning, August 5th. On August 13th, ten days after feeling that first pain in his chest, Chris was discharged from the hospital. He came back a few days later on August 19th due to fever, returning home once again on August 23rd, twenty days after it all began.

Chris and others like him represent a very vulnerable group of individuals. With no heart murmur and no symptoms until the sudden onset of severe chest pain, especially at a young age when this might be least expected, Chris experienced bicuspid aortic valve disease in its most treacherous form: an aneurysm silently forming in the chest of a seemingly healthy, athletic individual who has no idea they are at risk of aortic tearing or rupture. And then one day, without warning, their aorta tears.

Chris describes what happened to him as "life-changing" and says, "The good news is, I survived and according to the surgeon and cardiologist the prognosis is good." 

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