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Aortic Dissection


The Manual's Editorial Staff

Last full review/revision Apr 2021| Content last modified Apr 2021
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What is an aortic dissection?

The aorta is the main blood vessel (artery) that carries blood away from your heart to the rest of your body. The wall of the aorta has several layers. A small tear in the inside layer lets blood force its way into the wall of the aorta. The pressure of the blood then separates the inside layer from the middle layer of the aorta. This separating is called dissection.

As long as the tear in the lining is open, the dissection can keep growing down the aorta. This creates space for blood to flow where it shouldn't. As the tear grows, it can close off smaller blood vessels connected to the aorta or block proper blood flow in the aorta.

  • High blood pressure is the most common cause of an aortic dissection

  • You may have sudden, terrible pain across your chest or in your back between your shoulder blades

  • Doctors may give you medicine to lower your blood pressure and do surgery to fix the tear

  • About half of aortic dissections happen in people over 60 years old

Understanding Aortic Dissection

Understanding Aortic Dissection

What causes an aortic dissection?

The most common cause of aortic dissection is having high blood pressure for a long time.

Less common causes of aortic dissection include:

  • Disorders that run in families and damage your body's tissues, such as Marfan syndrome

  • Birth defects of the heart and blood vessels

  • Hardening of the arteries, which can limit blood flow to organs and tissues (atherosclerosis)

  • Chest injuries, such as from a car crash or fall

What are the symptoms of aortic dissection?

The main symptom is sudden, terrible pain. Sometimes the pain is so bad that you faint. This pain is often across your chest or in your back between your shoulder blades. It can also be in your belly area or lower back.

An aortic dissection can cause other problems, such as:

  • Heart attack or other heart problems

  • Kidney failure

  • Nerve or spinal cord damage that causes tingling or an inability to move your legs

How can doctors tell if I have an aortic dissection?

Symptoms are usually obvious to doctors. To be sure it is a dissection, doctors may do tests, such as:

How do doctors treat an aortic dissection?

Doctors will admit you to the hospital. You'll get medicines to lower your blood pressure and heart rate. High blood pressure and a fast heart rate make the dissection grow quickly. Doctors then decide whether to do surgery.


During surgery, doctors remove as much of the torn area of the aorta as possible. They also rebuild the aorta with a tube (graft). If the aortic valve is leaking, they repair or replace it.

For less serious dissections, doctors may insert a graft into your aorta through an artery in your upper leg to repair the tear.


Whether or not you have surgery, you'll need medicines to keep your blood pressure down. Your medicines may include:

  • ACE inhibitors, which widen your arteries to lower blood pressure

  • Beta-blockers, which slow your heart rate

  • Cholesterol-lowering drugs, if you have hardening and narrowing of the arteries (atherosclerosis)

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