The aorta is a main artery that carries blood away from your heart to the rest of the body. The blood it carries is rich in oxygen, and your body relies on it for survival.

The aorta is about an inch wide and has an inner, middle, and outer layer.

A dissection of an aorta happens when the pressure or weakness inside the aorta causes the layers to split and break the aorta wall. This damage can lead to blood leaking into the body. Your organs may receive less blood than they need as a result. This is a life threatening condition that requires prompt emergency medical care.

Experiencing a sudden aortic dissection is rare but serious. Untreated, this condition can be fatal. The warning signs can be hard to spot, and the condition can affect people of all ages.

The symptoms of aortic dissection can be difficult to distinguish from other heart conditions, like a heart attack.

Chest pain and pain in the upper back are typical symptoms of this condition.

The pain may be severe, and feel like something is sharp or tearing in your chest.

Unlike in the case of a heart attack, the pain usually begins suddenly when the dissection starts to occur and seems to move around. This happens as more parts of your body become affected.

As the condition progresses, you may also experience:

Aortic dissection is a medical emergency

If you experience the following symptoms, seek emergency medical care immediately:

  • sudden tearing pain in the chest, neck, jaw, belly, or shoulder
  • fainting
  • difficulty breathing
  • sudden weakness

Call 911 or local emergency services.

The aorta travels upward when it first leaves your heart. This vessel is called the ascending aorta. It then arches downward, passing from your chest into your abdomen, and becomes your descending aorta.

Dissection can occur in either the ascending or descending part of your aorta or both.

There are two types of aortic dissections. They’re categorized by the part of the aorta affected. A dissection can involve the ascending and descending aorta.

Type A

A Type A dissection means the tear involves your ascending aorta, regardless of where the initial tear occurred.

Type B

Dissections that start in the descending aorta are considered type B. They tend to be less life threatening than type A dissections if they do not involve the ascending aorta.

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Illustration by Wenzdai Figueroa

Although the exact cause of aortic dissections is unknown, certain risk factors may put you at a higher risk.

Anything that weakens your aortic wall can cause dissection. It includes inherited conditions in which your body tissues develop abnormally, like Marfan syndrome, atherosclerosis, and untreated hypertension, as well as accidental injuries to the chest.

Aortic dissection happens in about 5 to 30 cases per 1 million people each year. While it’s most common in men ages 40 to 70, this condition can affect anyone.

The other following factors may also increase your risk:

Aortic dissections may be difficult to diagnose. The condition and symptoms can be mistaken for other illnesses.

Because an aortic dissection can cause serious damage in a short amount of time, it requires prompt diagnosis and treatment.

Without prompt treatment, this condition may cause fatal complications, like:

Your doctor may perform a CT scan of the aorta to clearly and accurately see any tears. The scan may also help identify target areas for surgery.

The doctor may also use:

A TEE involves passing a device that emits sound waves down your throat until it’s close to the area at the level of your heart. Then, ultrasound waves create an image of your heart and aorta.

Aortic dissection is an emergency medical condition. If left untreated, the mortality rate is as high as 76 percent within the first 48 hours after dissection and may be as high as 90 percent.

Surgery

Surgery is used to treat type A aortic dissections.

Open-heart surgery can be performed to repair the dissection and damage while improving blood flow. The surgeon may make a surgical incision to the chest or abdomen to repair the aorta. In some cases, people with type A aortic dissection may receive a prosthetic valve or prosthetic ascending aorta.

For type B aortic dissections, endovascular surgery may also be performed to repair the aorta or place a stent, which is a hollow tube placed in your body to support a blocked pathway. This type of surgery is less invasive than open-heart surgery. It may also be performed for people with a complicated type B aortic dissection.

After the procedure, the doctor may monitor you in the hospital for possible complications, including stroke and acute kidney injury.

Medication

The doctor may also prescribe medications to lower your blood pressure, no matter the dissection type. For example, beta-blockers are medications that can reduce both your heart rate and blood pressure.

You may also receive medication to relieve your pain, like morphine.

The outlook for people with dissection of the aorta depends on different factors, including their age, health history, and the severity of the dissection.

In some cases, your organs may not receive enough blood flow due to the dissection. This can be restored with surgery. But when organs go for too long without enough oxygen, they can experience irreversible damage that can lead to long-term side effects.

For example, if your brain experiences reduced blood flow, it can cause permanent issues with motor control and cognitive function. Therapy may be needed to help someone who experienced this to walk, speak, and perform other activities of daily living.

In other cases, aortic dissection can be fatal without prompt treatment.

The U.S. Preventive Services Task Force recommends that all males ages 65 to 75 years old, who are former or current smokers, receive an ultrasound screening for aortic aneurysms. Early detection is essential to improve your chances of survival if you show signs of the condition.

If you have cardiac disease or other heart-related conditions, it’s essential to:

  • Report any symptoms promptly.
  • Get regular check-ups.
  • Always prioritize your heart health through diet and exercise.
  • Take all medications, including blood pressure and cholesterol drugs, as directed by your physician.

Aortic dissection is a serious condition caused by a tear in the layers of the aorta, which is a major artery that carries oxygen-rich blood to your body. Certain risk factors, like chest injury and structural abnormalities, may increase your risk for this condition.

Although aortic dissection is rare, you can take steps to lessen the likelihood that you may experience it. These steps include attending regular medical check-ups, treating risk factors like high blood pressure, and avoiding injuries to your chest.