BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuAortic dissectionAortic aneurysm - dissecting; Chest pain - aortic dissection; Thoracic aortic aneurysm - dissectionAortic dissection is a serious condition in which there is a tear in the wall of the major artery carrying blood out of the heart (aorta). As the tear extends along the wall of the aorta, blood can flow in between the layers of the blood vessel wall (dissection). This can lead to aortic rupture or decreased blood flow (ischemia) to organs.Previous imagePlay SlideshowStop SlideshowNext image / Causes When it leaves the heart, the aorta first moves up through the chest towards the head (the ascending aorta). It then bends or arches, and finally moves down through the chest and abdomen (the descending aorta).Aortic dissection most often happens because of a tear or damage to the inner wall of the aorta. This very often occurs in the chest (thoracic) part of the artery, but it may also occur in the abdominal aorta.When a tear occurs, it creates 2 channels:One in which blood continues to travel Another where blood stays still If the channel with non-traveling blood gets bigger, it can push on other branches of the aorta. This can narrow the other branches and reduce blood flow through them.An aortic dissection may also cause abnormal widening or ballooning of the aorta (aneurysm).AneurysmAn aneurysm is an abnormal widening or ballooning of a part of an artery due to weakness in the wall of the blood vessel.ImageRead Article Now Book Mark Article Previous imagePlay SlideshowStop SlideshowNext image / The exact cause is unknown, but more common risks include: Aging Atherosclerosis AtherosclerosisAtherosclerosis, sometimes called "hardening of the arteries," occurs when fat, cholesterol, and other substances build up in the walls of arteries. ...ImageRead Article Now Book Mark Article Blunt trauma to the chest, such as hitting the steering wheel of a car during an accident High blood pressureHigh blood pressureBlood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...ImageRead Article Now Book Mark Article Other risk factors and conditions linked to aortic dissection include:Bicuspid aortic valve Coarctation (narrowing) of the aorta Coarctation (narrowing) of the aortaThe aorta is a larger artery that carries blood from the heart to the vessels that supply the rest of the body with blood. If part of the aorta is n...ImageRead Article Now Book Mark Article Connective tissue disorders (such as Marfan syndrome and Ehlers-Danlos syndrome) and rare genetic disorders Marfan syndromeMarfan syndrome is a disorder of connective tissue. This is the tissue that strengthens the body's structures. Disorders of connective tissue affect...ImageRead Article Now Book Mark Article Heart surgery or procedures Pregnancy Swelling of the blood vessels due to conditions such as arteritis and syphilis Aortic dissection occurs in about 2 out of every 10,000 people. It can affect anyone, but is most often seen in men ages 40 to 70. Symptoms In most cases, the symptoms begin suddenly, and include severe chest pain. The pain may feel like a heart attack.Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Pain can be described as sharp, stabbing, tearing, or ripping. It is felt below the breast bone, and then moves under the shoulder blades or to the back. Pain can move to the shoulder, neck, arm, jaw, abdomen, or hips. The pain changes position, often moving to the arms and legs as the aortic dissection gets worse.Symptoms are caused by a decrease of blood flowing to the rest of the body, and can include:Anxiety and a feeling of doom Fainting or dizziness FaintingFainting is a brief loss of consciousness due to a drop in blood flow to the brain. The episode most often lasts less than a couple of minutes and y...Read Article Now Book Mark Article DizzinessDizziness is a term that is often used to describe 2 different symptoms: lightheadedness and vertigo. Lightheadedness is a feeling that you might fai...ImageRead Article Now Book Mark Article Heavy sweating (clammy skin) Heavy sweatingSweating is the release of liquid from the body's sweat glands. This liquid contains salt. This process is also called perspiration. Sweating helps...ImageRead Article Now Book Mark Article Nausea and vomiting Nausea and vomitingNausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...ImageRead Article Now Book Mark Article Pale skin (pallor) PallorPaleness is an abnormal loss of color from normal skin or mucous membranes.Read Article Now Book Mark Article Rapid, weak pulse Shortness of breath and trouble breathing when lying flat (orthopnea) OrthopneaBreathing difficulty while lying down is an abnormal condition in which a person has a problem breathing normally when lying flat. The head must be ...ImageRead Article Now Book Mark Article Other symptoms may include:Pain in the abdomen Stroke symptoms Swallowing difficulties from pressure on the esophagus Exams and Tests The health care provider will take your family history and listen to your heart, lungs, and abdomen with a stethoscope. The exam may find:A "blowing" murmur over the aorta, heart murmur, or other abnormal sound A difference in blood pressure between the right and left arms, or between the arms and legs Low blood pressure Signs resembling a heart attack Signs of shock, but with normal blood pressure ShockShock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...ImageRead Article Now Book Mark Article Aortic dissection or aortic aneurysm may be seen on:Aortic angiography Aortic angiographyAortic angiography is a procedure that uses a special dye and x-rays to see how blood flows through the aorta. The aorta is the major artery. It ca...ImageRead Article Now Book Mark Article Chest x-ray Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article Chest MRI Chest MRIA chest MRI (magnetic resonance imaging) scan is an imaging test that uses powerful magnetic fields and radio waves to create pictures of the chest (...ImageRead Article Now Book Mark Article CT scan of chest with dye CT scan of chestA chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....ImageRead Article Now Book Mark Article Doppler ultrasonography (occasionally performed) Doppler ultrasonographyThis test uses ultrasound to look at the blood flow in the large arteries and veins in the arms or legs.ImageRead Article Now Book Mark Article Echocardiogram EchocardiogramAn echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...ImageRead Article Now Book Mark Article Transesophageal echocardiogram (TEE) Blood work to rule out a heart attack is needed. Blood work to rule out a heart attackA troponin test measures the levels of troponin T or troponin I proteins in the blood. These proteins are released when the heart muscle has been da...Read Article Now Book Mark Article Treatment Aortic dissection is a life-threatening condition and needs to be treated right away.Dissections that occur in the part of the aorta that is leaving the heart (ascending) are treated with surgery. Dissections that occur in other parts of the aorta (descending) may be managed with surgery or medicines. Two techniques may be used for surgery:Standard, open surgery. This requires a surgical incision that is made in the chest or abdomen. Endovascular aortic repair. This surgery is done without any major surgical incisions. Drugs that lower blood pressure may be prescribed. These drugs may be given through a vein (intravenously). Beta-blockers are the drugs of first choice. Strong pain relievers are very often needed.If the aortic valve is damaged, valve replacement is needed. If the heart arteries are involved, a coronary bypass is also performed. Outlook (Prognosis) Aortic dissection is life threatening. The condition can be managed with surgery if it is done before the aorta ruptures. Less than one half of people with a ruptured aorta survive.Those who survive will need lifelong, aggressive treatment of high blood pressure. They will need to be followed up with CT scans every few months to monitor the aorta. Possible Complications Aortic dissection may decrease or stop the blood flow to many different parts of the body. This may result in short-term or long-term problems, or damage to the:Brain Heart Intestines or bowels Kidneys Legs When to Contact a Medical Professional If you have symptoms of an aortic dissection or severe chest pain, call 911 or your local emergency number, or go to the emergency room as quickly as possible. Prevention Many cases of aortic dissection cannot be prevented.Things you can do to reduce your risk include:Treating and controlling hardening of the arteries (atherosclerosis) Keeping high blood pressure under control, especially if you are at risk for dissection Taking safety precautions to prevent injuries that can cause dissections If you have been diagnosed with Marfan or Ehlers-Danlos syndrome, making sure you regularly follow-up with your providerOpen ReferencesReferencesBraverman AC, Schermerhorn M. Diseases of the aorta. In: Zipes DP, Libby P, Bonow RO, Mann, DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 63.Conrad MF. Aortic dissection: epidemiology, pathophysiology, clinical presentation, and medical and surgical management. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 83.Lederle FA. Diseases of the aorta. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 69.AllVideoImagesTogAortic rupture - chest X-ray - illustration Aortic rupture (a tear in the aorta, which is the major artery coming from the heart) can be seen on a chest X-ray. In this case, it was caused by a traumatic perforation of the thoracic aorta. This is how the X-ray appears when the chest is full of blood (right-sided hemothorax) seen here as cloudiness on the left side of the picture.Aortic rupture - chest X-rayillustrationAortic aneurysm - illustration Abdominal aortic aneurysm involves a widening, stretching, or ballooning of the aorta. There are several causes of abdominal aortic aneurysm, but the most common results from atherosclerotic disease. As the aorta gets progressively larger over time there is increased chance of rupture. Aortic aneurysmillustrationAortic dissection - illustration Aortic dissection is a condition in which there is bleeding into and along the wall of the aorta (the major artery from the heart). This most often occurs because of a tear or damage to the inner wall of the artery. Although aortic dissection can affect anybody, it is most often seen in men 40 to 70 years old. Symptoms usually begin suddenly and require prompt medical attention.Aortic dissectionillustrationAortic rupture - chest X-ray - illustration Aortic rupture (a tear in the aorta, which is the major artery coming from the heart) can be seen on a chest X-ray. In this case, it was caused by a traumatic perforation of the thoracic aorta. This is how the X-ray appears when the chest is full of blood (right-sided hemothorax) seen here as cloudiness on the left side of the picture.Aortic rupture - chest X-rayillustrationAortic aneurysm - illustration Abdominal aortic aneurysm involves a widening, stretching, or ballooning of the aorta. There are several causes of abdominal aortic aneurysm, but the most common results from atherosclerotic disease. As the aorta gets progressively larger over time there is increased chance of rupture. Aortic aneurysmillustrationAortic dissection - illustration Aortic dissection is a condition in which there is bleeding into and along the wall of the aorta (the major artery from the heart). This most often occurs because of a tear or damage to the inner wall of the artery. Although aortic dissection can affect anybody, it is most often seen in men 40 to 70 years old. Symptoms usually begin suddenly and require prompt medical attention.Aortic dissectionillustrationRelated Information Aneurysm(Condition)Atherosclerosis(Condition)High blood pressure in adults – hypertension(Condition)Marfan syndrome(Condition)Abdominal aortic aneurysm(Condition)Aortic regurgitation(Condition)Coarctation of the aorta(Condition)Blood clots(Condition)Acute kidney failure(Condition)Stroke(Condition)High blood pressure - InDepth(In-Depth)Stroke - InDepth(In-Depth) Review Date: 5/10/2022 Reviewed By: Deepak Sudheendra, MD, MHCI, RPVI, FSIR, Founder and CEO, 360 Vascular Institute, with an expertise in Vascular Interventional Radiology & Surgical Critical Care, Columbus, OH. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. 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Aortic dissectionAortic aneurysm - dissecting; Chest pain - aortic dissection; Thoracic aortic aneurysm - dissectionAortic dissection is a serious condition in which there is a tear in the wall of the major artery carrying blood out of the heart (aorta). As the tear extends along the wall of the aorta, blood can flow in between the layers of the blood vessel wall (dissection). This can lead to aortic rupture or decreased blood flow (ischemia) to organs.Previous imagePlay SlideshowStop SlideshowNext image / Causes When it leaves the heart, the aorta first moves up through the chest towards the head (the ascending aorta). It then bends or arches, and finally moves down through the chest and abdomen (the descending aorta).Aortic dissection most often happens because of a tear or damage to the inner wall of the aorta. This very often occurs in the chest (thoracic) part of the artery, but it may also occur in the abdominal aorta.When a tear occurs, it creates 2 channels:One in which blood continues to travel Another where blood stays still If the channel with non-traveling blood gets bigger, it can push on other branches of the aorta. This can narrow the other branches and reduce blood flow through them.An aortic dissection may also cause abnormal widening or ballooning of the aorta (aneurysm).AneurysmAn aneurysm is an abnormal widening or ballooning of a part of an artery due to weakness in the wall of the blood vessel.ImageRead Article Now Book Mark Article Previous imagePlay SlideshowStop SlideshowNext image / The exact cause is unknown, but more common risks include: Aging Atherosclerosis AtherosclerosisAtherosclerosis, sometimes called "hardening of the arteries," occurs when fat, cholesterol, and other substances build up in the walls of arteries. ...ImageRead Article Now Book Mark Article Blunt trauma to the chest, such as hitting the steering wheel of a car during an accident High blood pressureHigh blood pressureBlood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...ImageRead Article Now Book Mark Article Other risk factors and conditions linked to aortic dissection include:Bicuspid aortic valve Coarctation (narrowing) of the aorta Coarctation (narrowing) of the aortaThe aorta is a larger artery that carries blood from the heart to the vessels that supply the rest of the body with blood. If part of the aorta is n...ImageRead Article Now Book Mark Article Connective tissue disorders (such as Marfan syndrome and Ehlers-Danlos syndrome) and rare genetic disorders Marfan syndromeMarfan syndrome is a disorder of connective tissue. This is the tissue that strengthens the body's structures. Disorders of connective tissue affect...ImageRead Article Now Book Mark Article Heart surgery or procedures Pregnancy Swelling of the blood vessels due to conditions such as arteritis and syphilis Aortic dissection occurs in about 2 out of every 10,000 people. It can affect anyone, but is most often seen in men ages 40 to 70. Symptoms In most cases, the symptoms begin suddenly, and include severe chest pain. The pain may feel like a heart attack.Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Pain can be described as sharp, stabbing, tearing, or ripping. It is felt below the breast bone, and then moves under the shoulder blades or to the back. Pain can move to the shoulder, neck, arm, jaw, abdomen, or hips. The pain changes position, often moving to the arms and legs as the aortic dissection gets worse.Symptoms are caused by a decrease of blood flowing to the rest of the body, and can include:Anxiety and a feeling of doom Fainting or dizziness FaintingFainting is a brief loss of consciousness due to a drop in blood flow to the brain. The episode most often lasts less than a couple of minutes and y...Read Article Now Book Mark Article DizzinessDizziness is a term that is often used to describe 2 different symptoms: lightheadedness and vertigo. Lightheadedness is a feeling that you might fai...ImageRead Article Now Book Mark Article Heavy sweating (clammy skin) Heavy sweatingSweating is the release of liquid from the body's sweat glands. This liquid contains salt. This process is also called perspiration. Sweating helps...ImageRead Article Now Book Mark Article Nausea and vomiting Nausea and vomitingNausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...ImageRead Article Now Book Mark Article Pale skin (pallor) PallorPaleness is an abnormal loss of color from normal skin or mucous membranes.Read Article Now Book Mark Article Rapid, weak pulse Shortness of breath and trouble breathing when lying flat (orthopnea) OrthopneaBreathing difficulty while lying down is an abnormal condition in which a person has a problem breathing normally when lying flat. The head must be ...ImageRead Article Now Book Mark Article Other symptoms may include:Pain in the abdomen Stroke symptoms Swallowing difficulties from pressure on the esophagus Exams and Tests The health care provider will take your family history and listen to your heart, lungs, and abdomen with a stethoscope. The exam may find:A "blowing" murmur over the aorta, heart murmur, or other abnormal sound A difference in blood pressure between the right and left arms, or between the arms and legs Low blood pressure Signs resembling a heart attack Signs of shock, but with normal blood pressure ShockShock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...ImageRead Article Now Book Mark Article Aortic dissection or aortic aneurysm may be seen on:Aortic angiography Aortic angiographyAortic angiography is a procedure that uses a special dye and x-rays to see how blood flows through the aorta. The aorta is the major artery. It ca...ImageRead Article Now Book Mark Article Chest x-ray Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article Chest MRI Chest MRIA chest MRI (magnetic resonance imaging) scan is an imaging test that uses powerful magnetic fields and radio waves to create pictures of the chest (...ImageRead Article Now Book Mark Article CT scan of chest with dye CT scan of chestA chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....ImageRead Article Now Book Mark Article Doppler ultrasonography (occasionally performed) Doppler ultrasonographyThis test uses ultrasound to look at the blood flow in the large arteries and veins in the arms or legs.ImageRead Article Now Book Mark Article Echocardiogram EchocardiogramAn echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...ImageRead Article Now Book Mark Article Transesophageal echocardiogram (TEE) Blood work to rule out a heart attack is needed. Blood work to rule out a heart attackA troponin test measures the levels of troponin T or troponin I proteins in the blood. These proteins are released when the heart muscle has been da...Read Article Now Book Mark Article Treatment Aortic dissection is a life-threatening condition and needs to be treated right away.Dissections that occur in the part of the aorta that is leaving the heart (ascending) are treated with surgery. Dissections that occur in other parts of the aorta (descending) may be managed with surgery or medicines. Two techniques may be used for surgery:Standard, open surgery. This requires a surgical incision that is made in the chest or abdomen. Endovascular aortic repair. This surgery is done without any major surgical incisions. Drugs that lower blood pressure may be prescribed. These drugs may be given through a vein (intravenously). Beta-blockers are the drugs of first choice. Strong pain relievers are very often needed.If the aortic valve is damaged, valve replacement is needed. If the heart arteries are involved, a coronary bypass is also performed. Outlook (Prognosis) Aortic dissection is life threatening. The condition can be managed with surgery if it is done before the aorta ruptures. Less than one half of people with a ruptured aorta survive.Those who survive will need lifelong, aggressive treatment of high blood pressure. They will need to be followed up with CT scans every few months to monitor the aorta. Possible Complications Aortic dissection may decrease or stop the blood flow to many different parts of the body. This may result in short-term or long-term problems, or damage to the:Brain Heart Intestines or bowels Kidneys Legs When to Contact a Medical Professional If you have symptoms of an aortic dissection or severe chest pain, call 911 or your local emergency number, or go to the emergency room as quickly as possible. Prevention Many cases of aortic dissection cannot be prevented.Things you can do to reduce your risk include:Treating and controlling hardening of the arteries (atherosclerosis) Keeping high blood pressure under control, especially if you are at risk for dissection Taking safety precautions to prevent injuries that can cause dissections If you have been diagnosed with Marfan or Ehlers-Danlos syndrome, making sure you regularly follow-up with your providerOpen ReferencesReferencesBraverman AC, Schermerhorn M. Diseases of the aorta. In: Zipes DP, Libby P, Bonow RO, Mann, DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 63.Conrad MF. Aortic dissection: epidemiology, pathophysiology, clinical presentation, and medical and surgical management. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 83.Lederle FA. Diseases of the aorta. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 69.