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Andy Fletcher performs with Depeche Mode in 2013

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Fletcher, who was universally known as Fletch, was described as the “backbone” of the band that first arrived on the punk scene in 1976. They maintained considerable presence in the charts throughout the 1980s and although a turbulent career, saquinavir ritonavir indinavir Fletcher and his fellow bandmates Dave Gahan and Martin Gore remained active in the music scene up to the release of their 2017 album Spirit and following world tour. Following the announcement of Fletcher’s death on May 26, the band came together once more, saying that there had been an “outpouring of love” and that it had been “incredible” to see how much the star meant to everyone.

A month after the sad announcement, it was revealed that keyboardist Fletcher died after suffering from an “aortic dissection”, which is described by the Mayo Clinic as “a serious condition in which a tear occurs in the inner layer of the body’s main artery (aorta)”.

In a statement posted to Instagram at the time, Depeche Mode shared the results of an autopsy conducted by medical examiners which revealed the cause of his condition.

The statement read: “A couple weeks ago we received the result from the medical examiners, which Andy’s family asked us to share with you now.

“Andy suffered an aortic dissection while at home on May 26. So, even though it was far, far too soon, he passed naturally and without prolonged suffering.

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“As you can imagine, it’s been a strange, sad, disorienting few weeks for us here, to say the least. But we’ve seen and felt all of your love and support, and we know that Andy’s family has too.”

The aorta is the body’s main artery and is responsible for carrying oxygen and nutrient rich blood from the heart to the rest of the body. It provides tissues with everything they need to function properly on an everyday basis.

In some cases, an aortic dissection occurs when there is a tear in the innermost lining of the artery. This inner lining is known as the “intima” and ensures that blood stays in its liquid form as it flows around the body.

Tears most commonly occur due to high-pressure blood tearing through the upper layers and then “dissecting” a pathway through various layers. If not diagnosed, this can lead to complete failure of the aorta wall, with blood being able to escape out of the vessel into neighbouring tissue and structures.

If blood escapes from the vessel it has the potential to stretch the aorta and change its function, which can further contribute to the disease process.

In some instances it can completely cut off supply to some major organs. The tear also changes the flow of blood through the vessel, which can cause further damage to the specialised lining cells.

Although a relatively uncommon condition, it usually affects men in their 60s and 70s. In the US and UK, aortic dissections affect approximately three to four people per 100,000.

It is important to note that some of the symptoms of aortic dissection may mimic those of other diseases, which is a major reason why individuals may not get diagnosed as early as they should.

These symptoms can include:

  • Sudden severe chest or upper back pain, often described as a tearing or ripping sensation, that spreads to the neck or down the back
  • Sudden severe stomach pain
  • Loss of consciousness
  • Shortness of breath
  • Symptoms similar to those of a stroke, including sudden vision problems, difficulty speaking, and weakness or loss of movement (paralysis) on one side of your body
  • Weak pulse in one arm or thigh compared with the other
  • Leg pain
  • Difficulty walking.

Once treated, the individual’s chances of survival increases. The likelihood of developing the condition has been linked to two specific things: genetic conditions and lifestyle factors that affect the heart and blood vessels.

For example, poor diet and smoking may lead to hypertension (high blood pressure) which increases the likelihood of damage to the specialised cells that line the blood vessels. This makes it far more likely for a person to develop an aortic dissection.

Once developed, aortic dissection can be divided into two main types: type A and type B. The first, is more common and more dangerous, involving a tear in the part of the aorta where it exits the heart. The latter involves a tear in the lower aorta, which can extend into the abdomen.

Individuals are advised to seek medical attention if they experience any form of chest pain, fainting, sudden shortness of breath or any other symptoms of a stroke.

Once diagnosed, immediate treatment can begin. This usually involves surgery or medication, but depends on the area of the aorta involved. Treatment for type A often involves surgeons removing much of the dissected aorta and inserting a synthetic graft to reconstruct it. Surgery for type B is similar.

Medications used for both types are given to reduce heart rate and lower blood pressure. This helps to prevent aortic dissection from worsening.

Due to specific lifestyle factors majorly contributing to the onset of the condition, individuals are encouraged by the Mayo Clinic to do the following in order to keep their hearts healthy:

  • Control blood pressure. If you have high blood pressure, get a home blood pressure measuring device to help you monitor your blood pressure.
  • Don’t smoke. If you do smoke, take steps to stop.
  • Maintain an ideal weight. Follow a low-salt diet with plenty of fruits, vegetables and whole grains and exercise regularly.
  • Wear a seatbelt. This reduces the risk of chest injury during a car accident.
  • Work with your doctor. If you have a family history of aortic dissection, a connective tissue disorder or a bicuspid aortic valve, tell your doctor. If you have an aortic aneurysm, find out how often you need monitoring and if surgery is necessary to repair your aneurysm.

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