Table of ContentsView AllTable of ContentsWhat Is It?TypesSymptomsWhen to Call 911Causes and Risk FactorsDiagnosisTreatmentComplicationsOutlookPrevention
Table of ContentsView All
View All
Table of Contents
What Is It?
Types
Symptoms
When to Call 911
Causes and Risk Factors
Diagnosis
Treatment
Complications
Outlook
Prevention
An aortic dissection is an uncommon emergency medical condition that occurs when there is a tear, or rupture, in the inner layer of the aorta. The aorta is the biggest artery in the human body, and it carries fresh, oxygenated blood from the heart to the rest of the body.
When a tear or rupture occurs in the inner lining of the aorta, blood can flow into the space between the inner and outer layers of the artery, creating a false channel or “dissection.”
This article covers what you need to know about aortic dissection, including types, symptoms, when to call 911, causes, diagnosis, and treatment.
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What Happens With Aortic Dissection
The aorta is the main artery that takes oxygenated blood from the heart to supply the rest of the body. The aorta’s three layers are:
An aortic dissection begins with a tear in the inner layer of the aorta. This tear allows blood to enter the wall of the aorta, creating a false channel between the inner and outer layers of the artery.
Aortic Dissection
As blood enters the false channel, the inner and outer layers of the aortic wall can become separated, leading to the characteristic “dissection” of the aorta.
The presence of this false channel can disrupt normal blood flow in the aorta. Depending on the location and extent of the dissection, blood flow to various organs and tissues can be compromised. This may lead to several complications, such as:
Immediate medical treatment is essential. Aortic dissections are often managed surgically and with medication, and the specific approach used depends on the individual case.
Types of Aortic Dissection
There are two main types of aortic dissection, and each depends on location:
Type A
A type A aortic dissection means the tear or problem starts in the part of the aorta that’s close to the heart, or the upper portion of the aorta.
This type is usually more serious and urgent because it can affect important blood vessels that go to the brain and other vital organs. Healthcare providers often treat Type A dissections with open-heart surgery to fix the damaged part of the aorta.
Type B
Type B is the type occurring farther away from the heart. It means the tear happens in the lower part of the aorta, toward or within the abdomen. Type B dissections are still serious, but they tend to be a bit less urgent than type A.
Healthcare providers might treat type B dissections with medications to lower blood pressure or sometimes with a procedure in which they put a special tube (stent) into the blood vessel to help seal off the tear and prevent it from worsening.
Aortic Dissection Symptoms
Aortic dissection symptoms typically appear suddenly, and the pain can feel severe, similar to a heart attack. The pain experienced during an aortic dissection is often described as sharp, stabbing, or even tearing.
Initially, this discomfort may be localized beneath the breastbone but may move beneath the shoulder blades or even toward the back. As the condition progresses, the pain may move around, traveling to areas like the jaw, neck, shoulders, arms, abdomen, or even the hips.
Additional symptoms that may accompany an aortic dissection include:
Abdominal Aortic Aneurysm: Symptoms With and Without Rupture
If you or someone else is experiencing aortic dissection symptoms, you should immediately call911. Symptoms like severe chest or back pain, especially if it feels like tearing or ripping, should not be taken lightly. Aortic dissections are life-threatening emergencies, and prompt medical attention is crucial for diagnosis and treatment.
Aortic Dissection Causes and Risk Factors
The exact cause of an aortic dissection can vary, but some common risk factors and causes include:
How Aortic Dissection Is Diagnosed
Healthcare providers use several methods to diagnose an aortic dissection.
First, they perform a thorough physical exam, checking things like blood pressure, listening to the heart, and evaluating pulses. Noticing signs like a heart murmur or abnormal pulses can raise their suspicion of aortic dissection.
It’s important to know that certain common tests, like an electrocardiogram (ECG or EKG) or chest X-ray, may not always detect an aortic dissection.
To get a more accurate diagnosis, healthcare providers often turn to advanced imaging tests, including:
These tests are very good at spotting aortic dissections, but which one is used can depend on what the hospital has available and the patient’s specific needs. CT scans, for instance, use contrast dye to see inside the aorta and its branches.
Transesophageal echocardiograms involve an ultrasound probe placed down the esophagus to image the heart and aorta. MRI scans, while highly accurate, take longer and may not be the first choice.
How Aortic Dissection Is Treated
The treatment for an aortic dissection often involves a combination of surgical and medical interventions. The specific treatment approach depends on various factors, including the location and extent of the dissection and the overall health of the patient.
Medications
Controlling blood pressure is a crucial part of managing aortic dissection. Medications, such asbeta-blockersandvasodilators, are often administered to reduce the force of blood pumping against the weakened aortic wall. This helps decrease the risk of the dissection progressing or rupturing.
Surgery
Surgery to repair the damaged aorta and prevent further complications. The two main surgical approaches are:
Aortic Dissection Complications
Aortic dissection disrupts blood flow and can lead to various complications, including:
Prompt treatment is crucial to minimize damage to these organs and improve recovery chances.
Outlook for Aortic Dissections
The outlook for aortic dissections depends on several factors, including the location and extent of the dissection, how quickly it is diagnosed and treated, and the patient’s overall health.
However, aortic dissections continue to pose significant mortality risk (risk of dying). A substantial portion, around 30%, do not survive past their arrival at the emergency room, and even with surgical intervention, mortality rates range between 20% to 30%.
Even with successful treatment, individuals may require long-term follow-up care and lifestyle changes to manage related health risks, such as high blood pressure and aortic aneurysms.
How to Prevent Aortic Dissection
Aortic dissection is not always preventable. However, there are proactive measures you can take to minimize your risk, such as:
Summary
While aortic dissections cannot always be prevented, managing risk factors like atherosclerosis and high blood pressure, taking safety precautions, and seeking regular follow-up care for underlying conditions can help minimize the chances of this life-threatening condition.
Immediate medical attention is essential if symptoms arise, such as sudden, intense chest or back pain. If you or a loved one has signs of an aortic dissection, call 911 or go to your local emergency room as soon as possible.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.The American Heart Association.Your Aorta: The pulse of life.Medline Plus.Aortic dissection.Komutrattananont P, Mahakkanukrauh P, Das S.Morphology of the human aorta and age-related changes: Anatomical facts.Anat Cell Biol. 2019;52(2):109. doi: 10.5115/acb.2019.52.2.109Centers for Disease Control and Prevention.Aortic aneurysm.Harris C, Croce B, Cao C.Type A aortic dissection. Annals of cardiothoracic surgery. 2016;5(3):256-256. doi: 10.21037/acs.2016.05.04Harris CG, Croce B, Tian DH.Type B aortic dissection. Annals of Cardiothoracic Surgery. 2014;3(3):339-339. doi: 10.3978/j.issn.2225-319X.2014.05.10Medline Plus.Echocardiogram.Medline Plus.MRI.Emergency Medicine Residents Association.Thoracic aortic dissection.Society for Vascular Surgery.Open surgery treatment of an aortic dissection.Society for Vascular Surgery.Endovascular treatment of an aortic dissection.Levy D, Goyal A, Grigorova Y, et al.Aortic Dissection. In: StatPearls. StatPearls Publishing; 2023
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.The American Heart Association.Your Aorta: The pulse of life.Medline Plus.Aortic dissection.Komutrattananont P, Mahakkanukrauh P, Das S.Morphology of the human aorta and age-related changes: Anatomical facts.Anat Cell Biol. 2019;52(2):109. doi: 10.5115/acb.2019.52.2.109Centers for Disease Control and Prevention.Aortic aneurysm.Harris C, Croce B, Cao C.Type A aortic dissection. Annals of cardiothoracic surgery. 2016;5(3):256-256. doi: 10.21037/acs.2016.05.04Harris CG, Croce B, Tian DH.Type B aortic dissection. Annals of Cardiothoracic Surgery. 2014;3(3):339-339. doi: 10.3978/j.issn.2225-319X.2014.05.10Medline Plus.Echocardiogram.Medline Plus.MRI.Emergency Medicine Residents Association.Thoracic aortic dissection.Society for Vascular Surgery.Open surgery treatment of an aortic dissection.Society for Vascular Surgery.Endovascular treatment of an aortic dissection.Levy D, Goyal A, Grigorova Y, et al.Aortic Dissection. In: StatPearls. StatPearls Publishing; 2023
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
The American Heart Association.Your Aorta: The pulse of life.Medline Plus.Aortic dissection.Komutrattananont P, Mahakkanukrauh P, Das S.Morphology of the human aorta and age-related changes: Anatomical facts.Anat Cell Biol. 2019;52(2):109. doi: 10.5115/acb.2019.52.2.109Centers for Disease Control and Prevention.Aortic aneurysm.Harris C, Croce B, Cao C.Type A aortic dissection. Annals of cardiothoracic surgery. 2016;5(3):256-256. doi: 10.21037/acs.2016.05.04Harris CG, Croce B, Tian DH.Type B aortic dissection. Annals of Cardiothoracic Surgery. 2014;3(3):339-339. doi: 10.3978/j.issn.2225-319X.2014.05.10Medline Plus.Echocardiogram.Medline Plus.MRI.Emergency Medicine Residents Association.Thoracic aortic dissection.Society for Vascular Surgery.Open surgery treatment of an aortic dissection.Society for Vascular Surgery.Endovascular treatment of an aortic dissection.Levy D, Goyal A, Grigorova Y, et al.Aortic Dissection. In: StatPearls. StatPearls Publishing; 2023
The American Heart Association.Your Aorta: The pulse of life.
Medline Plus.Aortic dissection.
Komutrattananont P, Mahakkanukrauh P, Das S.Morphology of the human aorta and age-related changes: Anatomical facts.Anat Cell Biol. 2019;52(2):109. doi: 10.5115/acb.2019.52.2.109
Centers for Disease Control and Prevention.Aortic aneurysm.
Harris C, Croce B, Cao C.Type A aortic dissection. Annals of cardiothoracic surgery. 2016;5(3):256-256. doi: 10.21037/acs.2016.05.04
Harris CG, Croce B, Tian DH.Type B aortic dissection. Annals of Cardiothoracic Surgery. 2014;3(3):339-339. doi: 10.3978/j.issn.2225-319X.2014.05.10
Medline Plus.Echocardiogram.
Medline Plus.MRI.
Emergency Medicine Residents Association.Thoracic aortic dissection.
Society for Vascular Surgery.Open surgery treatment of an aortic dissection.
Society for Vascular Surgery.Endovascular treatment of an aortic dissection.
Levy D, Goyal A, Grigorova Y, et al.Aortic Dissection. In: StatPearls. StatPearls Publishing; 2023
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