The sudden death of U.S. Senator Lindsey Graham of South Carolina has brought national attention to aortic dissection, a life-threatening medical emergency that occurs when a tear develops in the inner layer of the aorta, the body's largest artery. According to the American Heart Association, blood surges through the tear, causing the layers of the aortic wall to separate—a condition that can be rapidly fatal if not diagnosed and treated promptly.
The aorta carries oxygen-rich blood from the heart to the rest of the body. Aortic disease can manifest when the aortic wall weakens, leading to a bulge (aneurysm) or a tear (dissection). In a dissection, the tear creates a flap that extends along the aorta, potentially causing complications such as heart attack, bleeding, or rupture through the back of the wall. Symptoms may include sudden, severe chest pain; back pain; neck or jaw pain; and feeling faint, weak, or short of breath. These symptoms can mimic other cardiovascular emergencies, making rapid diagnosis essential.
Dr. Manesh Patel, volunteer president of the American Heart Association and chief of cardiology at Duke University School of Medicine, explained that aortic dissection is more common in men than women, with an estimated incidence of 5 to 30 people per million. Most cases occur between ages 50 and 70. Key risk factors include atherosclerosis (hardening of the arteries) and high blood pressure. Certain genetic disorders of connective tissue can lead to aneurysms and aortic disease in younger adults. Dr. Patel emphasized that individuals with risk factors such as high blood pressure, tobacco use, or a family history of aortic aneurysms or dissections should discuss screening with their physicians.
The 2022 American Heart Association/American College of Cardiology Guideline for the Diagnosis and Management of Aortic Disease stresses rapid recognition and treatment of acute aortic syndromes. It also recommends family screening, including genetic testing and imaging, for first-degree relatives of patients with certain aortic aneurysms or dissections, as well as consistent imaging and surveillance practices. The full guideline is available at https://www.ahajournals.org/doi/10.1161/CIR.0000000000001106.
The American Heart Association notes that while a ruptured aneurysm or severe aortic dissection can be immediately fatal, prompt diagnosis and treatment can be lifesaving. The organization can connect reporters with experts to discuss what an aortic dissection is, risk factors, warning signs, advances in diagnosis and treatment, and the importance of family history and screening. For more information, visit the American Heart Association's newsroom at https://newsroom.heart.org.
