What is an aortic dissection?

An aortic dissection is when there is a tear in the wall of your aorta — the largest blood vessel in your body.

Your aorta is about as thick as a garden hose. It carries blood from your heart through your chest and into your abdomen (tummy).

When there is a tear in the inside wall of your aorta, the layers of the blood vessel wall come apart and blood surges in between them. Blood then flows between the layers of the wall, instead of through the lumen (middle of the blood vessel).

An aortic dissection is a rare but very dangerous condition. It happens most often to males aged in their 50s, 60s and 70s.

What are the types of aortic dissection?

Doctors use different ways to classify aortic dissection, mainly based on which part of your aorta is affected by the tear.

What are the symptoms of aortic dissection?

The main symptom of aortic dissection is a sudden, excruciating pain in your chest, upper back or abdomen.

The pain feels sharp, ripping, stabbing or tearing. It might also spread into your jaw, neck or down your back.

Other possible symptoms or aortic dissection include:

• losing consciousness or fainting
• breathlessness
• feeling weak, numb or tingly on one side, like a stroke
• pain or paralysis in your legs, or difficulty walking
• being very pale and sweaty
• vomiting

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What causes aortic dissection?

Aortic dissection is when there is a tear in the wall of your aorta. The tear can occur in an area of the aortic wall that is weak.

You are more at risk of aortic dissection if you:

• have uncontrolled high blood pressure
• have hardening of the arteries
• have an aortic aneurysm
• were born with a defect in your aorta or aortic heart valve
• have had previous heart surgery or a heart procedure
• have a family history of aortic disease

Some genetic conditions can increase your risk or aortic dissection. These include:

• Marfan syndrome
• Ehlers-Danlos syndrome

Smoking, using cocaine and heavy lifting can also increase your risk.

When should I see my doctor?

Aortic dissection is a medical emergency.

If you have symptoms that include a sudden, severe pain in your chest or upper back, call triple zero (000) straight away and ask for an ambulance.

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How is aortic dissection diagnosed?

Your doctor will ask about your symptoms and examine you. They will check for a pulse that is weaker on one side of your body than on the other. They will also check your blood pressure on both arms and listen to your chest.

Tests that can help with diagnosing aortic dissection include:

• blood tests
• an electrocardiogram (ECG)
• a chest x-ray
• an echocardiogram
• a CT scan

Other tests that may be needed are:

• an angiogram
• an MRI scan
• an ultrasound scan

How is aortic dissection treated?

Your doctor may give you several initial treatments including:

• pain-relief medicines
• oxygen
• fluids though a drip
• medicines to lower your blood pressure and reduce your heart rate

Further treatment depends on which part of your aorta is affected. It can involve:

• surgery
• medicines
• monitoring and treatment of complications

Some people need an aortic valve replacement or coronary bypass surgery.

If you have an aortic dissection, you may need to keep taking blood pressure medicine for the rest of your life. You will also need regular checks with your doctor.

Can aortic dissection be prevented?

Look after your heart and blood vessels by leading a healthy lifestyle:

• give up smoking
• stay physically active
• keep to a healthy weight

It’s important to manage high blood pressure, high cholesterol and diabetes if you have these conditions.

Also, follow your doctor’s advice if you have:

• an aortic aneurysm
• a genetic condition that increases your risk of aortic dissection
• a family history of aortic dissection

Complications of aortic dissection

Aortic dissection is often life-threatening, but it is rare.

An aortic dissection can affect the flow of blood and oxygen to your body. If it causes your aorta to rupture (burst), it’s usually fatal.

Other complications can include:

• heart valve problems
• angina or heart attack
• cardiac tamponade (a life-threatening condition where blood or fluid collects around your heart and stops the heart from pumping blood properly)
• stroke

Resources and support

The Heart Foundation has information and support for people with heart conditions.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.