Aortic dissection happens when there is a tear in the inner layer of your aorta — the major artery that carries blood out of your heart. Aortic dissection is a medical emergency because it can lead to a life-threatening aortic rupture.
At UPMC, our cardiothoracic and vascular surgery experts work together to provide fast diagnosis and advanced treatment for aortic dissection.
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Arteries have three layers. Aortic dissection is a potentially life-threatening condition in which a tear develops in the inner layer of your aorta, the major artery carrying blood out of your heart.
With an aortic dissection, blood surges through the tear into and along the wall of the aorta, causing the inner and middle layers to separate (dissect). If the blood-filled channel ruptures through the aortic wall, aortic dissection is usually fatal.
Aortic dissection occurs in roughly two out of every 10,000 people.
Causes of an aortic dissection include:
Untreated high blood pressure is the most common cause of aortic dissection, followed by atherosclerosis, or plaque buildup in the arteries. Over time, high blood pressure and plaque buildup can weaken the wall of the aorta — especially in people who may have inherited conditions that make them more likely to develop blood vessel disorders.
Aortic dissection occurs in approximately two out of every 10,000 people. It can affect anyone but is most common in men aged 40-70.
Most commonly associated with high blood pressure, an aortic dissection also can result from atherosclerosis.
Other risk factors include:
Aortic dissection is a tear in the inner layer of the aorta. Type A aortic dissection is the most common type of dissection and occurs closer to the heart. It can be life threatening and requires immediate surgical intervention to repair or replace the segment of the aorta where the tear began.
An aortic dissection is a medical emergency that requires immediate treatment. If left untreated, aortic dissection can progress to an aortic rupture, which causes severe internal bleeding and is often fatal.
You may not be able to control some of your aortic dissection risk factors, such as aging, bicuspid aortic valve, and traumatic injury. However, preventing heart disease and chronic conditions can reduce the risk that you will develop aortic dissection. You may be able to reduce your risk by:
Aortic dissection can occur suddenly, and most cases appear in the emergency department as a sudden catastrophic event.
You may experience a sharp, tearing pain in your chest or upper back, or feel pain in your:
Aortic dissection is a medical emergency that requires immediate treatment. If you have symptoms of an aortic dissection, dial 911 right away.
Since most aortic dissections are diagnosed in the emergency room, your emergency physician will perform a physical exam followed by imaging studies to confirm the diagnosis.
If your doctor suspects you have an aortic dissection, they may order imaging studies including:
Aortic dissection is a life-threatening condition requiring hospitalization, usually in an intensive care unit (ICU).
The condition can be managed if it is diagnosed and treated before the aorta ruptures.
Fewer than half of patients with a ruptured aorta survive; however, 60 percent of patients treated for aortic dissection are alive 10 years later.
Aortic dissection treatments often include medication or surgical repair, depending on the severity and location of the dissection. Treatment options may include:
If your aortic dissection is located in the descending part of your aorta and is not obstructing any blood vessels, your doctor may treat your condition with medication to lower blood pressure and relieve pain.
During your emergency aortic dissection repair, your surgeon will remove the largest possible area of the dissected aorta, block the entry of blood into your aortic wall, and replace your aorta with a synthetic graft.
Your vascular surgeon will open your chest or abdomen where your aortic dissection is located. Your surgeon will repair your aorta through the incision using a synthetic graft.
Your surgeon will repair your aorta using a graft attached to a small tube called a catheter. The catheter is inserted into a small incision in your leg and guided to the damaged area of your aorta.
If your aortic valve is damaged, your surgeon may replace your aortic valve with a plastic or metal mechanical valve, or a bioprosthetic valve, which is usually made from pig tissue.
If your heart arteries are obstructed, blocked, or damaged, your surgeon may perform a CABG procedure to restore blood flow to your heart.
Early treatment for aortic dissection can improve your chances of survival. Sixty percent of patients who are successfully treated for aortic dissection are alive 10 years later.
By UPMC Editorial Staff. Last reviewed on 2024-10-01.
