The sudden death of U.S. Senator Lindsey Graham of South Carolina, attributed to an aortic dissection, has brought national attention to this rare but often fatal medical emergency. An aortic dissection occurs when a tear develops in the inner layer of the aorta, the body's largest artery, allowing blood to surge through the tear and separate the layers of the arterial wall. Without rapid diagnosis and treatment, the condition can be rapidly fatal, according to the American Heart Association.
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 either a bulge (aneurysm) or a tear (dissection). When a tear occurs, blood creates a flap that can extend along the aorta, potentially causing complications such as heart attack, bleeding, or rupture through the back of the wall. Symptoms often include sudden, severe chest or back pain, neck or jaw pain, and feelings of faintness, weakness, or shortness of breath. These symptoms can mimic other cardiovascular emergencies, making rapid diagnosis essential.
According to American Heart Association volunteer president Manesh Patel, M.D., FAHA, aortic dissection is more common in men than women, with an estimated incidence of 5 to 30 people per million. Most dissections occur between ages 50 and 70. Key risk factors include atherosclerosis (hardening of the arteries), high blood pressure, tobacco use, and family history of aortic aneurysms or dissections. Certain genetic connective tissue disorders can also predispose younger adults to aortic disease. Dr. Patel advises individuals with these risk factors to discuss aortic aneurysm risk and screening with their physicians.
The 2022 American Heart Association/American College of Cardiology Guideline for the Diagnosis and Management of Aortic Disease emphasizes rapid recognition and treatment of acute aortic syndromes, family screening including genetic testing and imaging for first-degree relatives of patients with certain aortic aneurysms or dissections, and consistent imaging and surveillance practices. These guidelines aim to improve outcomes through early detection and timely intervention.
The American Heart Association continues to fund research and provide resources to advance the understanding and treatment of aortic disease. For more information on aortic dissection, risk factors, and warning signs, visit heart.org.
