Aortic dissection is a serious condition in which the inner layer of the aorta, the large blood vessel branching tears off the heart. The blood flows through the tear, causing the inner and middle layers of the aorta to separate (dissect). If the blood-filled channel ruptures through the outside aortic wall, aortic dissection is often fatal.

It is a relatively uncommon condition which most frequently occurs in men in their 60s and 70s. Symptoms of aortic dissection may mimic those of other diseases, often leading to delays in diagnosis. However, when an aortic dissection is detected early and treated promptly, the chance of survival are improved.

Symptoms

The symptoms of aortic dissection may be similar to those of other heart problems, such as a heart attack. Typical symptoms include:

  • Loss of consciousness,
  • Sudden severe chest or upper back pain, often described as a tearing, ripping or shearing sensation, that radiates to the neck or down the back,
  • Sudden difficulty speaking, loss of vision, weakness or paralysis of one side of the body, similar to those of a stroke,
  • Weak pulse in one arm compared with the other,
  • Shortness of breath.

Causes

The weakened area of the aortic wall is the cause of the aortic dissection. Chronic high blood pressure may stress the aortic tissue, making it more susceptible to tearing. You can also be born with a condition associated with a weakened and enlarged aorta, such as Marfan syndrome, bicuspid aortic valve or other rarer conditions associated with weakening of the walls of the blood vessels. Rarely, aortic dissections are caused by traumatic injury to the chest area, such as during accidents and mishaps.

There are two types of aortic dissections, depending on which part of the aorta is affected:

  • Type A. This is  a more common and dangerous type and involves a tear in the part of the aorta where it exits the heart or a tear in the upper aorta (ascending aorta), which may extend into the abdomen.
  • Type B. This involves a tear in the lower aorta only (descending aorta), which may also extend into the abdomen.

Risk factors

Risk factors for aortic dissection include:

  • Uncontrolled high blood pressure (hypertension),
  • Hardening of the arteries (atherosclerosis),
  • Weakened and bulging artery (pre-existing aortic aneurysm),
  • An aortic valve defect (bicuspid aortic valve),
  • A narrowing of the aorta at birth (aortic coarctation).

Complications

An aortic dissection can lead to:

  • Death due to severe internal bleeding,
  • Organ damage, such as kidney failure or life-threatening intestinal damage,
  • Stroke,
  • Aortic valve damage (aortic regurgitation) or rupture into the lining around the heart (cardiac tamponade).

Prevention

Here are a few tips to reduce the risk of an aortic dissection:

  • Control blood pressure,
  • Don't smoke,
  • Maintain an ideal weight.

If you have a genetic condition that increases the risk of aortic dissection, the doctor may recommend medications, even if the blood pressure is normal.