Hoang, who is 1.8 m tall and weighs 90 kg, regularly engages in high-intensity training. The afternoon before his hospital admission, he lifted heavy weights, 170-200 kg, for an extended period without any unusual signs. The next morning, he woke up with a sudden, sharp chest pain, feeling like "a thousand needles piercing his heart." He then collapsed to the floor and was rushed to Tam Anh General Hospital TP HCM for emergency care.

Associate Professor, Doctor Vu Huu Vinh, Director of the Thoracic and Vascular Surgery Center, assessed the patient's condition as critical. A CT scan revealed a dissection of the thoracic aorta, extending down to the abdominal aorta and reaching the roots of both iliac arteries. The dissection showed a tendency to spread towards the ascending aortic arch, indicating a high risk of mortality. Due to Hoang's frequent high-intensity gym workouts, his blood flow and pressure increased significantly, accelerating the vascular dissection and worsening his condition, according to Associate Professor Vinh.

Hoang underwent emergency surgery, combining open surgery with the placement of a thoracic aortic stent graft.

An emergency surgical team controls bleeding and treats Hoang's aortic dissection. Photo: Tam Anh General Hospital

To create a safe zone (landing zone) for the stent graft to anchor, the surgical team repositioned the arterial branches supplying the brain and both arms closer to the aortic root. This procedure was challenging because the patient's endothelium was severely damaged after the incident.

Associate Professor Vinh clamped one side of the blood vessel to reposition it. "If clamped too tightly, the patient's blood pressure would drop to 0, and the heart would stop immediately; but if clamped too loosely, suturing would be impossible," Associate Professor Vinh stated.

After moving the arterial branches supplying the brain and arms to a safe position, the team sequentially placed three stent grafts to reconstruct the true lumen, seal the endothelial tear, and restore blood flow to the organs below.

Post-surgery, Hoang was conscious, his blood pressure was stable, and blood circulation through his thoracic aorta and renal arteries was good.

Hoang revealed that he regularly trains with very heavy weights (170-200 kg) and had previously experienced ruptured eye blood vessels, torn muscles, and burst capillaries. Recently, he often stayed up late and had a history of a left ventricular aneurysm 10 years prior, which he did not have checked regularly. According to Associate Professor Vinh, all these factors contributed to the patient's critical condition in a short period.

Aortic dissection occurs when the inner lining (endothelium) tears, allowing blood to flow into the arterial wall. This creates a "false lumen" that compresses the true lumen, similar to a clogged pipe preventing blood from reaching various body parts. If not treated promptly within the "golden hour," patients can suffer multi-organ failure and rapid death.

Associate Professor Vinh advises bodybuilders and individuals engaging in high-intensity sports to undergo regular heart and blood vessel examinations. Gym-goers should avoid overusing supplements and muscle-building substances (like whey protein or products of unknown origin). They also need to adhere to a proper rest regimen and consult with a cardiologist to determine an appropriate level of exertion.

Bao Anh