The sudden death of U.S. Senator Lindsey Graham of South Carolina, attributed to an aortic dissection, has brought attention to this often-fatal medical emergency. An aortic dissection is a tear in the inner layer of the aorta, the body's largest artery, allowing blood to surge through the tear and separate the layers of the aortic wall. According to the American Heart Association, this condition can be rapidly fatal if not diagnosed and treated promptly.
The aorta carries oxygen-rich blood from the heart to the rest of the body. Aortic disease can occur when the aortic wall is weakened, leading to a bulge (aneurysm) or a tear (dissection). In a dissection, blood passes through the tear, creating a flap that can extend and cause complications such as heart attack, bleeding, or rupture through the back of the wall. Symptoms may include sudden, severe chest pain, back pain, neck or jaw pain, and feeling faint, weak, or short of breath. These symptoms can mimic other cardiovascular emergencies, making rapid diagnosis essential.
According to American Heart Association volunteer president Manesh Patel, M.D., FAHA, aortic dissection is more common in men than women, with an estimated incidence of 5 to 30 people per million. Most people experience a dissection between the ages of 50 and 70. Risk factors include atherosclerosis (hardening of the arteries), high blood pressure, and genetic disorders of connective tissue that can lead to aneurysms and aortic disease in younger adults. Dr. Patel advises that people with risk factors such as high blood pressure, tobacco use, or a family history of aortic aneurysms or dissections should discuss aortic aneurysm risk and screening with their physicians.
The 2022 American Heart Association/American College of Cardiology Guideline for the Diagnosis and Management of Aortic Disease emphasizes rapid recognition and treatment of acute aortic syndromes, family screening including genetic testing and imaging for first-degree relatives of patients with certain aortic aneurysms or aortic dissection, and consistent imaging and surveillance practices.
The American Heart Association provides resources to understand what an aortic dissection is, its risk factors and warning signs, advances in diagnosis and treatment, and the importance of family history and screening. Additional information is available from the 2022 consumer news story and the 2022 news release.
