Aortic Dissection

Aortic dissection is a life-threatening condition that happens when two of three layers split in the aorta (the major artery from the heart to the body).

A tear in the inner lining of the aorta (the intima) allows blood to invade the middle layer (the media), creating a false passageway through which blood can flow. This false passageway steals a portion of the blood supply from the rest of the body. As a result, the main channel is narrowed and blood cannot pass through the aorta and its branches.

This condition can be fatal since it can lead to stroke, heart attack or a shut-off of blood flow to vital organs. The misdirected blood also may damage airways, lungs or the heart. If the dissection ruptures, bleeding can be catastrophic.

This rare but deadly condition robs 13,000 Americans yearly of their lives, according to the Centers for Disease Control and Prevention.

Aortic dissections often run in families. Any family history of close relatives with aortic aneurysm, dissection or rupture, or any family history of unexplained sudden death should be reported to your physician.

Other risk factors for aortic dissection include:

• High blood pressure
• Advancing age
• Male gender
• Atherosclerosis
• Inflammatory diseases that damage the blood vessels
• Certain genetic conditions that weaken connective tissue, such as Marfan syndrome and Ehlers-Danlos syndrome
• Pregnancy
• Smoking
• Untreated syphilis
• Illicit drug use

The most likely symptom of aortic dissection is sudden and severe pain in the chest, upper back, shoulder or stomach.

Since symptoms mimic those of a heart attack or another cause of chest pain, it can be difficult to arrive at a prompt diagnosis and lifesaving treatment may be delayed.

Other signs of aortic dissection may include:

• Stroke
• Fainting
• Shortness of breath
• Sudden weakness

To diagnose TAD (thoracic aortic dissection) and future risk, Institute-affiliated doctors use the latest noninvasive imaging of the chest and abdomen. A chest X-ray alone is inadequate.

These exams include:

• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Echocardiogram

Those with a family history of dissection or TAD, genetic conditions or only two layers (called a bicuspid aortic valve) need to be screened once to twice yearly.

Endovascular (minimally-invasive, catheter-based) surgery and open chest surgery can repair damage and replace the dissected area – such treatment is essential if the ascending aorta (the area nearest the heart) is involved. Descending thoracic aortic issues may need endovascular repair or may be managed with blood pressure and cholesterol-lowering drugs if no blood vessels are obstructed.

The good news is that 55% to 60% of aortic dissection patients are alive a decade later, reports the Journal of Cardiovascular and Thoracic Surgery. Hypertension medications and once to twice yearly screening help stave off future problems.

Scheduling an Appointment

Memorial Hermann-affiliated heart and vascular specialists are committed to using a multidisciplinary approach to provide exceptional care. Our highly skilled practitioners utilize leading-edge technology to diagnose and treat cardiovascular concerns.  

To learn more about aortic dissection and other heart conditions, visit Find a Doctor to schedule an appointment