Following the sudden death of U.S. Senator Lindsey Graham of South Carolina, widespread news reports indicate he suffered from an aortic dissection. An aortic dissection is a tear in the inner layer of the aorta, the body's largest artery. Blood surges through the tear, causing the layers of the aortic wall to separate (dissect).
Aortic dissection is a medical emergency that can be rapidly fatal if not diagnosed and treated promptly, according to the American Heart Association.
Key Facts
- The aorta, the largest artery in the body, carries oxygen-rich blood from the heart to the rest of the body.
- Aortic disease can occur when the aortic wall is weakened and either bulges (aneurysm) or tears (dissection).
- A tear in the wall of the aorta allows blood to pass through the tear and creates a flap that extends in the aorta and can lead to complications including heart attack, bleeding or rupture through the back of the wall.
- Symptoms may include:
- Sudden, severe chest pain
- Back pain
- Neck or jaw pain
- Feeling faint, weak or short of breath
- Symptoms can mimic other cardiovascular emergencies, making rapid diagnosis essential.
- A ruptured aneurysm or severe aortic dissection can be immediately fatal. However, prompt diagnosis and treatment can be lifesaving.
According to American Heart Association volunteer president Manesh Patel, M.D., FAHA, "Aortic dissection, a life-threatening disorder, 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 50-70. Risk factors for this life-threatening condition include atherosclerosis (hardening of the arteries) and high blood pressure. There are some genetic disorders of connective tissue that lead to aneurysms and aortic disease in younger adults. People with risk factors including high blood pressure, tobacco use, or family history of aortic aneurysms or dissections, should discuss aortic aneurysm risk and screening with their physicians." Patel is also chief of the division of cardiology, the Richard Stack Distinguished Professor of Medicine at Duke University School of Medicine, a senior investigator at the Duke Clinical Research Institute, and vice president of Heart and Vascular Services for Duke Health, Durham, North Carolina.
What the Guidelines Say
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.
- Consistent imaging and surveillance practices.
The American Heart Association can connect reporters with experts to discuss:
- What an aortic dissection is and why it can be deadly
- Risk factors and warning signs
- Advances in diagnosis and treatment
- The importance of family history and screening
- Recommendations from the 2022 ACC/AHA Guideline for Aortic Disease
