What is aortic dissection?
The aorta is the body’s largest blood vessel. It branches off the heart and delivers oxygenated blood to the body. The aorta wall is three layers thick. When the inner layer tears, blood can move between the middle and inner layer of the artery wall and separate (dissect). Early detection of aortic dissection is important because a tear that extends through the aorta wall is life-threatening.
Penn Medicine’s heart and vascular specialists have extensive experience treating aortic dissection, including complex cases that require emergency surgery. The Aorta Center team includes cardiac surgeons, vascular surgeons, imaging experts, and cardiologists who work together to plan the best approach for your care.
Types of aortic dissection
Providers classify aortic dissections into two types, based on where the tear occurs in the aorta:
- Type A: This is the more common type. It occurs in the part of the aorta closest to your heart, so it needs urgent care.
- Type B: This type occurs in the lower part of the aorta as it descends towards the abdomen.
Aortic dissection symptoms
When an aortic dissection occurs, you may experience symptoms similar to those of a heart attack:
- Pain: You may experience sudden severe pain in the chest, back, or abdomen. A radiating pain in the chest or upper back is described as a tearing or ripping sensation. The pain can extend to the legs and make walking difficult.
- Difficulty breathing: You may feel short of breath or lose consciousness.
- Paralysis: You may lose vision, the ability to speak, or the ability to use limbs on one or both sides of your body.
- Weak pulse: Because less blood is circulating in your body, you may notice a weakened pulse.
Aortic dissection risk factors
Risk factors for aortic dissection are similar to those of a thoracic aortic aneurysm:
- Family history of aortic aneurysm or dissection
- Genetic conditions that affect connective tissues in your body, such as Marfan syndrome or Ehlers-Danlos syndrome
- Bicuspid aortic valve disease
- High cholesterol, which can lead to plaque formation in the artery (atherosclerosis)
- Coronary artery disease (heart disease)
- High blood pressure
- Traumatic injury such as from a car accident or fall
Diagnosis of aortic dissection
Aortic dissection is often diagnosed in an emergency setting because symptoms can begin suddenly and look like other heart conditions. Your care team may first run tests to rule out other causes. If an aortic dissection is suspected, sensitive cardiothoracic imaging tests can help confirm the diagnosis.
Treating aortic dissection
Aortic dissection requires prompt care. The approach depends on where the tear occurs, how the dissection affects blood flow, and whether complications are present. Treatment may include medicines to control blood pressure and heart rate, surgery, or minimally invasive procedures. Type A and Type B dissections are generally treated differently.
Long-term care for aortic dissection
Care for aortic dissection doesn’t end with treatment. At Penn Medicine’s Aorta Center, providers monitor your aorta for life, watching for changes or problems that may develop over time through regular imaging and blood pressure management.
If your aortic dissection may be related to an inherited condition, we also offer genetic counseling to help you understand your risk. Because some aortic conditions can run in families, our advanced practice providers follow family members of people who’ve had aortic surgery, too, to help identify problems early.