An aortic tear is often a death sentence


DEAR DR. DONOHUE: I wrote to you previously about my wife’s death from an aortic dissection. She was in the hospital for a urinary tract infection and was being examined by a resident doctor so she could be released within 12 hours. All of a sudden, she cried out because of a sharp pain in her back. Then she closed her eyes and stopped breathing. I would like to know what caused this. Was it medicine, old age or high blood pressure? I have lost a lot of sleep over this shock. She was 82. — D.P.

ANSWER: Quite a number of people who suffer an aortic dissection die suddenly. It’s a catastrophic situation. The inner lining of the aorta tears. The aorta is the body’s largest artery, receiving blood from the heart and delivering it to all other body arteries. Blood rushes into the aortic tear and extends it. That can split the aorta.

Old age is one of the factors that bring on aortic dissection. Age weakens the aorta and its lining. High blood pressure is another important factor. Young people who suffer aortic dissections — and young people do have them — do so usually because of a genetic problem that weakens the aorta. Some well-known, young athletes have died from this condition.

A sudden, severe, tearing pain heralds a dissection. The pain can be felt in the front of the chest or in the back of it. Sweating is profuse. And the person often complains of trouble breathing. Your wife died so suddenly that she had no other signs except for the pain. Nothing could have been done to save your wife. Everything happened too quickly. In situations where the tear and bleeding are not so great, medicines are given to dampen the force of blood leaving the heart. The final solution, however, lies in repairing the torn aorta.

You have my sympathy. The sudden loss of a partner of so many years is something that must leave a hole in the heart.

DEAR DR. DONOHUE: I love licorice. I heard that eating too much of it is not healthy. Can you tell me what you know about this? — C.T.

ANSWER: I like it too. Real licorice, the kind made from the roots of the glycyrrhiza plant, is produced rarely in the United States. Glycyrrhizin, the main material in the roots, can upset sodium, potassium and water balance. Two to 3 ounces of licorice containing glycyrrhizin taken daily for weeks or months might cause a drop in blood potassium and a rise in blood pressure. Most licorice in the U.S. is artificially flavored with aniseed oil. It doesn’t have glycyrrhizin. There are no consequences from eating it.

The ingredients of glycyrrhizin licorice will list “licorice extract” or “licorice root powder.” If glycyrrhizin has been removed from root-derived licorice, the label says “DGL.” I bet you are not eating root-derived licorice. No red licorice contains glycyrrhizin. I like to say that word, “glycyrrhizin.” I’m trying to remember how to spell it for Scrabble.

DEAR DR. DONOHUE: I am 81 and in reasonably good health since dropping all prescription drugs. I was allergic to them all. I am doing much better now and can even run with my little dog part of the way home. My concern now is my hand tremors, diagnosed as benign essential tremor. They’re getting worse. Although I keep my good-sized apartment clean and do research and writing for others, I would like to find the best meds, foods or vitamins you can suggest for the tremor. — J.W.

ANSWER: “Benign” should not be part of “essential tremor.” It’s benign in the sense that it won’t kill you. It’s not benign in how it can disrupt life. It’s a shaking of the hands, head or voice that often runs in families. The shaky hands make eating, writing, sewing and all hand work difficult and sometimes impossible.

No foods or vitamins control the tremor. However, two relatively inexpensive medicines do. One is propranolol (Inderal), and the other is primidone (Mysoline). Start with a low dose of either drug, and increase the dose if need be.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from