What is aortic dissection?

Your blood vessels are made up of three layers of strong, but flexible tissues. An aortic dissection is a tear in the inner layer of the aorta, the largest blood vessel in the body. This is a very serious problem. When blood leaks through the tear, it collects between the inner and outer layers of the aorta and causes them to pull apart. It can block other important blood vessels, change the way the heart works, or cause the aorta to burst.

What is the cause?

The most common causes are:

• Uncontrolled high blood pressure that weakens the aortic wall over time
• Inherited diseases, such as Marfan syndrome, that weakens the aortic wall
• Birth defects that affect the aortic valve in your heart or that weaken blood vessels
• Atherosclerosis, or hardening of the arteries, in which fatty deposits called plaque build up in blood vessels and make them narrower
• Chest injury, such as from a car accident or being hit in the chest
• Aging

What are the symptoms?

Symptoms may include:

• Sudden, severe mid-chest, belly, or back pain
• Dizziness or fainting
• Shortness of breath
• Weakness and sweating
• Nausea or vomiting

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Chest X-ray
• An ECG (also called an EKG or electrocardiogram), which measures and records your heartbeat
• CT scan, which uses X-rays and a computer to show detailed pictures of the blood vessel wall and possible tears
• Angiogram, which uses dye injected into a vein and X-rays to look inside the heart and blood vessels
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the blood vessel wall and possible tears
• An echocardiogram, which uses sound waves (ultrasound) to see how well your heart is pumping
• Blood tests

How is it treated?

Aortic dissection is a medical emergency. Treatment must be started as soon as possible. You may be given medicine to relax you and fast-acting IV medicine to lower high blood pressure. You may need surgery to replace the weakened part of the aorta with a graft of man-made material. If you have a problem with the aortic valve in your heart, it may also be replaced.

How can I take care of myself and help prevent aortic dissection?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Make sure you know how and when to take your medicine. Do not take more or less than you are supposed to take.
• If you or a close relative have Marfan syndrome or other inherited diseases, talk with your healthcare provider about tests to check your risk for aortic dissection and medicine you can take to prevent it.
• If you are a smoker, try to quit.
• If you have high blood pressure or high cholesterol, carefully follow your healthcare provider’s instructions for keeping your condition under control.
• Lose weight if you are overweight and keeping a healthy weight.
• Eat a healthy diet that does not include foods high in salt, fat, and cholesterol.
• Exercise according to your healthcare provider’s instructions.
• Get enough rest and learn to use relaxation methods to manage stress.

Ask your healthcare provider:

• How and when you will hear your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.