What is an aortic dissection?

An aortic dissection is a tear in the inner wall of the aorta, the main blood vessel that travels from the heart. When this tear occurs, blood can flow through the layers of the aortic wall, weakening the aorta and potentially blocking blood flow downstream. These life-threatening effects can lead to aortic rupture or an inadequate supply of oxygenated blood, known as malperfusion, to critical organs (brain, kidneys, intestines, etc. ).

Are there multiple types of aortic dissections?

Yes, aortic dissections are classified as either Stanford Type A (Debakey Types I and II) or Stanford Type B (Debakey Type III):

Stanford Type A (Debakey Types I and II): Occurs in the ascending aorta and/or aortic arch with possible extension into the descending thoracic aorta.

Stanford Type B (Debakey Type III): Occurs in the descending thoracic and/or abdominal aorta only.

Who is at risk for aortic dissections?

Aortic dissection is a rare condition, but it most often affects:

• Adults ages 60 and older.

• Men, more commonly than women

• People with high blood pressure (the leading risk factor)

• Individuals with aortic aneurysms or prior heart conditions

• Genetic disorders that affect connective tissue, such as Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome

• People with a family history of aortic disease

Other contributing factors may include smoking, trauma, or stimulant drug use.

Causes and risk factors

The exact cause of aortic dissection is still unknown, but there are several associated risk factors, including:

• Aortic inflammation (Aortitis)

• Atherosclerosis (buildup of plaque in the arteries)

• An existing aneurysm

• Chronic high blood pressure

• Congenital anomalies (bicuspid aortic valve or aortic coarctation)

• Trauma

What are the symptoms of an aortic dissection?

Symptoms of an aortic dissection usually begin suddenly and can be severe.

The most common symptom of an aortic dissection is terrible, constant, ripping/tearing chest pain that may migrate to the upper back, neck, or abdomen. Other symptoms may include:

• Shortness of breath

• Fainting or dizziness

• Weakness, trouble speaking, or other stroke-like symptoms

• Rapid pulse or low blood pressure

Because symptoms can mimic a heart attack or stroke, diagnosis can be delayed. Immediate evaluation is critical.

How is it diagnosed?

Aortic dissection is a medical emergency and requires rapid diagnosis.

In addition to your physician getting your complete medical history and doing a physical exam, they may order any of the following tests:

• CT scan (the most common and fastest imaging tool)

• MRI

• Transesophageal echocardiogram (TEE)

• Chest X-ray (may show changes, but is not definitive)

Early diagnosis greatly improves survival.

Treatment options for an aortic dissection

In most cases, an aortic dissection is a life-threatening emergency, and immediate treatment is needed. All patients require medications to lower blood pressure and decrease the force of blood against the aortic wall. The decision to treat an aortic dissection with surgery is a complicated one and depends on multiple factors, including:

• Type of dissection [Stanford Type A (Debakey Types I and II) vs Stanford Type B (Debakey Type III)]

• Malperfusion of end organs (intestines, kidneys, etc.)

• Diameter of the aorta

• Persistent chest pain

• High blood pressure that does not respond to treatment or control

If requiring surgery, a Type A dissection typically requires an open operation where the surgeon replaces the diseased portion of the aorta with a synthetic tube. The aortic valve may also need to be replaced.

If requiring surgery, Stanford Type B (Debakey Type III) dissections can often be treated with thoracic endovascular aortic repair (TEVAR), in which a stent-graft is deployed through minimally invasive means into the aorta.

Regardless of treating an aortic dissection with medications or surgery, it is critical that all patients undergo long-term monitoring with ongoing, repeated CT scans, as the aorta is at high risk of degeneration (becoming aneurysmal) over time.

Frequently asked questions

Is an aortic dissection the same as an aneurysm?

No. An aneurysm is a bulge in the aorta, while a dissection is a tear. However, an aneurysm can increase the risk of a dissection.

How serious is an aortic dissection?

It is a life-threatening emergency. Without treatment, complications such as rupture or organ damage can occur quickly.

Can an aortic dissection be prevented?

Risk can be reduced by:

• Controlling blood pressure

• Avoiding smoking

• Managing cholesterol

• Monitoring known aortic conditions

What is the survival rate?

Survival depends on how quickly treatment begins. Early diagnosis and care greatly improve outcomes.

Should family members be screened?

If there is a family history or a known genetic condition, screening may be recommended. The UF Health Aortic Disease Center has genetic counselors on our team to help patients make decisions with as much information available as possible.

Expert aortic care at UF Health

At UF Health, patients with aortic dissection receive care from a highly specialized, multidisciplinary team experienced in managing both routine and complex aortic conditions. This team includes cardiothoracic surgeons, vascular surgeons, cardiologists, imaging experts, genetic counselors, therapists and more. From rapid diagnosis to advanced surgical and minimally invasive treatments, care is personalized to each patient’s needs.

If you or a loved one may be at risk, call the UF Health Aortic Disease Center at 352-273-5494 to learn more about screening, diagnosis and treatment options.

This entry was written by Gabrielle Massari, Marketing Content Writer, and reviewed for accuracy by Eric Jeng, MD. Generative AI was leveraged as part of the content creation process.