# What Is an Aortic Dissection?
An aortic dissection is a life-threatening emergency where the inner lining of the aorta, your body's largest artery, tears. Blood rushes through this tear into the artery's middle layer, creating a secondary channel that weakens the vessel wall. Without immediate treatment, the aorta can rupture completely, causing rapid, often fatal internal bleeding.
The condition strikes suddenly and with severe pain. Patients typically describe a tearing or ripping sensation in the chest or upper back, often radiating to the neck or shoulders. "Like a knife to the back" captures how devastating the sensation feels. Symptoms emerge with no warning in many cases.
Risk factors include uncontrolled high blood pressure, which accounts for the majority of aortic dissections. Age matters too. Men over 60 face higher risk than women of the same age, though dissections do occur at younger ages in people with connective tissue disorders like Marfan syndrome. Smoking, cocaine use, and severe physical exertion can trigger dissections in vulnerable individuals.
Doctors classify aortic dissections by location. Type A dissections involve the ascending aorta near the heart and demand emergency surgery. Type B dissections affect the descending aorta and sometimes respond to medications alone, though surgery may still be necessary.
Treatment moves fast. Emergency imaging with CT or ultrasound confirms the diagnosis within minutes. For Type A cases, surgeons must operate immediately to replace the damaged aortic segment. Even with surgery, mortality rates remain high. Type A dissections kill about 1-2% of patients per hour during the first 48 hours without treatment.
Blood pressure control is critical both before and after treatment. Doctors use powerful medications to reduce the force of blood flowing through the aorta, decreasing strain on the