An aortic dissection occurs when the inner lining of the aorta, the body's largest artery, tears. Blood enters the tear and forces the layers of the aorta apart, compromising blood flow to vital organs and threatening immediate death.
The condition strikes suddenly and without warning. Patients typically experience severe, tearing chest pain that radiates to the back. Some describe it as the worst pain of their lives. The aorta carries oxygen-rich blood from the heart to the entire body, so a dissection interrupts circulation to the brain, lungs, kidneys, and spinal cord within minutes.
Type A dissections, which affect the upper portion of the aorta nearest the heart, prove most lethal. Without emergency surgery, roughly 1 percent of patients die each hour during the first 48 hours. Type B dissections occur lower in the aorta and may be managed with medication initially, though they still carry serious risks.
Risk factors include high blood pressure, atherosclerosis, connective tissue disorders like Marfan syndrome, and cocaine use. Men over 60 face higher risk than women. Some people have genetic predispositions that weaken aortic tissue over time.
Diagnosis relies on imaging. Computed tomography scans show the dissection with clarity, allowing physicians to determine location and extent. Echocardiograms and MRI scans provide additional detail when needed.
Treatment depends on dissection type and location. Type A requires immediate open-heart surgery to repair or replace the damaged aorta section. Type B often responds to blood pressure control with medications, though surgery becomes necessary if complications develop.
The mortality rate remains high. About 30 percent of Type A patients die before reaching a hospital. For those who receive surgery, survival rates improve significantly, but complications including paralysis, kidney failure, and stroke