What Is an Aortic Dissection — and Why Is It So Dangerous

An aortic dissection, blamed for the sudden death of U.S. Sen. Lindsey Graham of South Carolina, is a rare medical condition so dangerous that half of the people who experience an aortic dissection never make it to the hospital.

It happens when there is a tear on the inner wall of the main artery responsible for carrying blood from your heart to other parts of your body.

What Are the Symptoms of an Aortic Dissection?

What makes an aortic dissection so challenging is that it can lead to immediate death. Someone may feel fine one moment. And then a moment later, they feel an intense, unrelenting chest pain – often described as the worst they’ve ever experienced.

There are some instances, however, where the onset is less severe. This can lead to delays in diagnosis, since the symptoms may suggest a range of possible problems, including heart attack and stroke. Milder symptoms can include:

• Stomach pain

• Shortness of breath

• Dizziness or loss of consciousness

• Low blood pressure

• A rapid, but weak, pulse

• Confusion

• Vision loss

• Stroke symptoms, including weakness on one side of your body or difficulty talking

• Unexplained sweating

What Causes an Aortic Dissection and Who Is at Risk?

An aortic dissection will have a sudden onset. Researchers believe most dissections are related to a fundamental weakness in the wall of the aorta. It may even be an inherited weakness.

The aorta consists of three layers that are fused together. When a tear happens, blood pushes its way through the opening, causing a split (the dissection) of the inner and middle layers of the aorta. The danger becomes even more pronounced if the blood breaks through the outer walls of the artery. An aortic dissection is estimated to occur in only three to four per 100,000 people.

Chronic high blood pressure plays a key role and is the top risk factor. That constant pressure can cause damage to aortic tissue, degrading its elasticity, making it stiffer and more vulnerable to a tear.

There is no way to predict who will have an aortic dissection. But other likely risk factors include:

• Atherosclerosis: the accumulation of cholesterol, fats and other substances on the walls of an artery

• Aortic aneurysm: a bulge in the wall of the aorta

• Bicuspid aortic valve: the valve has two flaps, instead of the normal three

• Aortic coarctation: A narrowing of the aorta that occurs during birth

• Certain genetic diseases, including Turner syndrome and Marfan syndrome

How Is an Aortic Dissection Diagnosed and Treated?

The key to life-saving treatment is quickly diagnosing the tear after the patient arrives in the emergency room. When the symptoms are of the minor variety, a clinical examination and CT scan of the chest are used to diagnose the condition.

One telltale sign of an aortic dissection is a blood pressure reading that varies from one arm to the other. It may also be difficult to find a pulse. A CT scan, which creates detailed images of chest, is the best tool for confirming an aortic dissection.

Once the condition is diagnosed, surgery will be needed (usually immediately) to remove the damaged aorta and replace it with a graft. Medicines may also be used to lower blood pressure to keep the tear from growing.

While this is a rare condition, it is also reminder about the dangers of high blood pressure, which increases your risk for wide range of diseases and disorders. Keeping your blood pressure under control can go a long way toward helping you live a healthier life.

This content is not AI generated.