Aortic Dissection

What is aortic dissection?

The aorta is a large blood vessel that runs down the middle of your body. Aortic dissection is a tear in the lining of the aorta. Blood then flows into the wall of the aorta. This can cause sudden, serious problems with heart function and blood flow in your body. It is a medical emergency. It can lead to death if not treated quickly.

What causes aortic dissection?

The aorta is the largest artery in the body. It sends blood with oxygen from the heart to the rest of the body. The top part of the aorta is called the thoracic aorta. This part arches over the top of the heart. The lower part is called the abdominal aorta.

Some problems, such as high blood pressure, can weaken an area of the aorta over time. This can cause a tear in the lining of that area. This most often happens in the part of the aorta closest to the heart. This is called Type A. Less common is a tear in the lining of the abdominal aorta. This is called Type B.

An aortic dissection can also be caused by an aortic aneurysm. This is a bulge in an area of the aorta’s wall.

Who is at risk for aortic dissection?

A person is more at risk for aortic dissection if they have any of these:

• Untreated high blood pressure

• Disorders such as Marfan syndrome and Ehlers Danlos syndrome

• Family history of aortic dissection

• An aortic aneurysm

• Atherosclerosis

• Polycystic kidney disease

• Bicuspid aortic valve

• Coarctation of the aorta

• Pregnancy

What are the symptoms of aortic dissection?

Symptoms can occur a bit differently in each person. They can include:

• Sudden chest, neck, or jaw pain that may be severe or mild

• Along with chest pain, a feeling like tearing or ripping that spreads to the back

• Belly or side pain

• Fainting

• Weak pulse

• Loss of feeling or movement on 1 side of the body

• Shortness of breath

• Trouble swallowing

• Feeling of anxiety and dread

• Confusion

Many of these symptoms can be caused by other health conditions. Call 911 right away if these symptoms occur.

How is aortic dissection diagnosed?

The healthcare team will give you a physical exam and ask about your symptoms. You may have imaging tests to look at your aorta. You may have any of these:

• Chest X-ray

• Transesophageal echocardiogram (TEE)

• CT angiography (CTA)

• Magnetic resonance angiography (MRA)

How is aortic dissection treated?

For dissection in the top of the aorta (thoracic), surgery is done right away. Surgery may do any of these:

• Replace part of the aorta with artificial graft

• Repair it with mesh material

• Put in a mesh tube (stent) to support the torn area

A dissection lower in the aorta may be treated with medicine to control high blood pressure, such as beta blockers. A mesh stent may also be put in the aorta in that area.

What are possible complications of aortic dissection?

Blood may fill up the sac around the heart and cause it to stop beating normally. This is called cardiac tamponade. A tear all the way through the wall of the aorta causes a lot of bleeding inside the body. Both of these can lead to death quickly. Even with treatment, aortic dissection is a serious condition that can lead to death in 3 to 6 out of every 10 people who have it.

When should I call my healthcare provider?

Call 911 if you have any symptoms of aortic dissection.

Get medical care right away if you have any of these after treatment for aortic dissection:

• Fever of 100.4°F (38°C) or higher, or as advised by your provider

• Pain that gets worse

• Symptoms that don’t get better, or get worse

• New symptoms

Key points about aortic dissection

• The aorta is the largest artery in the body. It runs down the middle of your body. Aortic dissection is a tear in the lining of the aorta.

• It can cause sudden, serious problems with heart function and blood flow in your body. It is a medical emergency. It can lead to death if not treated quickly.

• A person is more at risk for aortic dissection if they have untreated high blood pressure.

• Symptoms can include severe pain and a tearing feeling in the chest that spreads to the back.

• Surgery may be done right away to replace or repair part of the aorta. In some cases, treatment is done with medicine.

• Even with treatment, aortic dissection is a serious condition that can lead to death.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.