The aorta is the largest artery in your body, carrying blood from your heart to the rest of your organs. An aortic dissection is a serious, life-threatening condition that happens when the inner layer of this major artery tears. Blood then surges through the tear, causing the inner and middle layers of the aorta to separate, or dissect.
Understanding the risks, recognizing the signs and knowing your screening options can make all the difference. This guide will walk you through what an aortic dissection is, its connection to aortic aneurysms and the critical information you need to protect your health.
What Causes Aortic Dissection?
An aortic dissection occurs when the wall of the aorta weakens. It is most often linked to aortic aneurysm, which is a fancy way of saying that the aorta is bigger than it is supposed to be.
In general, the bigger the aneurysm, the higher risk you may be for an aortic dissection.
These conditions don’t just appear out of nowhere. Several factors can increase your risk of developing an aneurysm or dissection.
Aortic Aneurysm Causes and Risk Factors
The weakening of the artery wall can be caused by several health and lifestyle factors. You may be at a higher risk if you:
- Are 50 or older: The risk for aortic conditions increases with age.
- Have high blood pressure: Also known as hypertension, this condition puts constant strain on your artery walls.
- Have high cholesterol: This can contribute to atherosclerosis, or the hardening of the arteries, which weakens them over time.
- Smoke: Smoking is a major risk factor as it damages blood vessels and raises blood pressure.
- Have a family history: A genetic predisposition to aortic aneurysms or dissections significantly increases your risk.
- Have certain medical conditions: Diabetes, heart disease, a history of stroke or prior cardiac procedures can elevate your risk.
Stress can also play an indirect role. Chronic stress can contribute to high blood pressure, which is a primary risk factor for aortic wall weakening.
Aortic Dissection Symptoms: Recognizing the Warning Signs
One of the most dangerous aspects of aortic aneurysms and dissections is that they can develop without any obvious signs. The vast majority of aortic aneurysms develop without any identifiable symptoms.
In fact, an aneurysm can grow very large before it causes any signs or symptoms. When symptoms of a dissection do appear, they are often sudden and severe. It’s crucial to seek immediate medical attention if you experience them.
The most common symptom is a sudden, severe and sharp pain, often described as a “tearing” or “ripping” sensation. The location of the pain can indicate where the dissection is occurring.
- Chest Pain: A tear in the part of the aorta running through the chest (thoracic aorta) can cause intense chest pain. This pain is most commonly felt in the middle of your chest or in the middle of your upper back, in between the shoulder blades.
- Back or Abdominal Pain: A tear in the part of the aorta in the abdomen can cause severe, sudden or persistent pain in the lower back or abdomen, which may spread to the groin or legs.
Other critical warning signs include:
- Dizziness or light-headedness
- Nausea and vomiting
- Rapid heart rate
- Clammy or sweaty skin
- Shortness of breath
Because these symptoms can mimic other conditions, such as a heart attack, a swift and accurate diagnosis is essential.
The Importance of Aortic Aneurysm Screening and Diagnosis
Since aortic conditions can be silent, screening is a powerful tool for early detection. Finding an aneurysm before it becomes a problem allows doctors to monitor it and intervene when necessary, preventing a life-threatening rupture or dissection.
How Screening Works
The most common screening method for a thoracic or abdominal aortic aneurysm is a simple ultrasound. This painless, non-invasive test uses high-frequency sound waves to create images of your aorta. A technician can measure the width of the artery to check for any dangerous features. The entire process is quick, often taking only 10 to 20 minutes.
Aortic Dissection Diagnosis
If a doctor suspects an aortic dissection based on your symptoms and risk factors, they will order imaging tests to get a clear view of your aorta. These diagnostic tools are more detailed than a screening ultrasound and can confirm a tear.
Common diagnostic methods include:
- Computed Tomography (CT) Scan: This is often the fastest and most effective way to diagnose an aortic dissection. It uses X-rays to create detailed cross-sectional images of the aorta.
- Transesophageal Echocardiogram (TEE): A probe is passed down the esophagus to provide clear, close-up images of the heart and aorta.
- Magnetic Resonance Angiogram (MRA): This test uses magnetic fields and radio waves to produce detailed images of your blood vessels.
Treatment and Life After Aortic Dissection
An aortic dissection is a medical emergency that requires immediate treatment. The approach depends on the type and location of the dissection.
- Type A Dissection: This involves the ascending aorta (the part closest to the heart) and is considered a surgical emergency. The damaged section of the aorta is typically replaced with a synthetic graft.
- Type B Dissection: This involves the descending aorta (in the left side of the chest or abdomen). It may be managed with medication to lower blood pressure and heart rate, reducing stress on the artery. Surgery may be needed if complications arise.
Survival rates for aortic dissection have improved significantly with advances in diagnosis and treatment. The key is getting medical help as quickly as possible. The longer a dissection goes untreated, the more dangerous it becomes.
Many people can and do live long, full lives after treatment for an aortic dissection. However, it requires lifelong management. This includes regular follow-up appointments, ongoing imaging to monitor the aorta, and strict control of blood pressure through medication and lifestyle changes.
How to Avoid Heart Aneurysms and Dissections
While you can’t change your genetics or age, you can take proactive steps to lower your risk:
- Manage Your Blood Pressure: Work with your doctor to keep your blood pressure in a healthy range.
- Don’t Smoke: If you smoke, quitting is the single most effective step you can take.
- Eat a Heart-Healthy Diet: Focus on eating a balanced diet that includes fruits, vegetables, whole grains and lean proteins.
- Exercise Regularly: Aim for moderate physical activity as recommended by your doctor.
- Get Screened: If you have risk factors, talk to your doctor about getting screened for an aortic aneurysm.
Understanding your risk and recognizing the symptoms of aortic dissection are vital. By taking control of your health and seeking timely medical care, you can protect yourself from this serious condition.
The Stony Brook Aortic Center at Stony Brook Medicine provides the most focused solution to a patient’s aortic disease. Our multidisciplinary team of physicians includes specialists in cardiac imaging, cardiovascular medicine, anesthesiology, cardiothoracic surgery and vascular surgery, who work closely with each other, and with patients’ referring physicians. We are committed to providing patients with an appointment within one week of referral from their physician, and expediting the delivery of care. For consultations/appointments with the surgical specialists of the Stony Brook Aortic Center Call (631) 638-1670.
