An aortic dissection is a tear in the wall of the aorta, the body’s largest blood vessel. The aorta carries oxygenated blood away from the heart.
An aortic dissection affects how blood flows, allowing it to seep between the layers of the aorta. Aortic dissection can lead to:
- An aortic aneurysm
- An aortic rupture (also known as a ruptured aortic aneurysm)
- Ischemia, or decreased blood flow to the body’s organs
All three health issues can be life-threatening.
Aortic dissection occurs most often in the thoracic aorta – the portion of the aorta that carries blood to the chest. But it can also affect the abdominal aorta, which carries blood through the abdomen and lower extremities.
There are two primary types of aortic dissection. Type A aortic dissection occurs in the ascending aorta, closest to the heart. Type B aortic dissection occurs in other portions of the aorta. Type A is the more serious of the two and, if not treated, can lead to a heart attack.
Surviving an aortic dissection requires prompt diagnosis and treatment. For people in Kentucky, the thoracic experts at the Comprehensive Vascular Clinic at the UK Gill Heart & Vascular Institute are here to provide care when minutes matter most.
In rare cases, an aortic dissection may not cause any symptoms and be discovered only through imaging scans for another condition. More commonly, symptoms of an acute aortic dissection come on suddenly and intensely. Symptoms may include:
- Anxiety
- Chest pain
- Difficulty breathing when lying flat
- Dizziness
- Fainting
- Heavy sweating
- Low blood pressure
- Nausea and vomiting
- Pale skin
- Rapid, weak pulse
- Shortness of breath
- Stroke-like symptoms, including weakness on one side of the body, difficulty communicating or issues with vision
Chest pain related to an aortic dissection is often described as sharp, stabbing, tearing or ripping, similar to a heart attack. As an aortic dissection worsens, pain may radiate to the shoulders, neck, arms, jaw, abdomen, hips or back.
Tears in the walls of blood vessels are often related to weakening or breakdown over time. The aortic wall may gradually weaken for years before finally tearing.
While researchers aren’t entirely certain why the aortic wall dissects in some people but not in others, the condition is believed to have a genetic component. Stress on the aortic wall due to high blood pressure can also lead to dissection in those who are at a higher risk.
In rare cases, acute injury to the chest, such as from a fall or car accident, can also cause aortic dissection.
Aortic dissection isn’t entirely preventable, but you can take steps to lower your risk:
- If you smoke, quit. Smoking and using other tobacco products weakens artery walls, increasing the risk of conditions such as aortic dissection. Avoid vaping and secondhand smoke as well.
- Take steps to manage high blood pressure. Aim to keep your blood pressure in a healthy range, which is 120/80 or lower. If you have high blood pressure, work with your primary care provider to treat the condition and lower your blood pressure.
- Wear your seatbelt. While it’s rare, severe trauma to the chest, like that from a car accident, may lead to aortic dissection.
- Watch your weight. Take steps to reach and maintain a healthy weight.
If you have a first-degree relative (parent, sibling or child) who has had an aortic dissection, talk with your provider about being screened for aortic disease.
High blood pressure is the most significant risk factor for aortic dissection. Blood pressure is the force with which blood hits the walls of blood vessels in the body. When your blood pressure is high, it can damage the aortic tissue, leading to a weakening of the aortic wall.
Other risk factors for aortic dissection include:
- Aging
- Atherosclerosis
- Cocaine use
- Congenital heart conditions
- Connective tissue disorders, including Ehlers-Danlos syndrome
- Family history of aortic dissection
- High cholesterol
- Pregnancy
- Smoking
- Traumatic injury to the chest
- Vasculitis
Conditions that affect the aorta, such as aortic valve disease, a narrowing of the aorta, and abdominal and thoracic aortic aneurysms, also increase your risk of aortic dissection.
Aortic dissection is life-threatening, but the odds of survival are significantly higher when dissection is caught before the aorta ruptures. According to the National Library of Medicine, less than 50 percent of those with a ruptured aorta survive.
Those who survive can live long and healthy lives. But they will require lifelong treatment to maintain a normal blood pressure and regular imaging scans to monitor the aorta.
In the event of an aortic dissection, you will seek initial care in the emergency department. As the area’s most advanced emergency department — and home to the UK Gill Heart & Vascular Institute — UK Albert B. Chandler Hospital is the preferred choice for patients experiencing emergency, life-threatening cardiovascular events. Whether you arrive by ambulance or are transferred from another hospital, you can rest assured that you are in the hands of the region’s most advanced vascular surgery team.
By the time you get to the hospital via emergency transport, Emergency Medical Services or the team that facilitated your transfer will have shared your symptoms and any known diagnosis with our emergency department.
Following emergency treatment, you may recover in our Cardiovascular Intensive Care Unit before being transferred to your hospital room. Once you are ready to go home or to an inpatient rehabilitation hospital, you will be assigned a UK Gill Heart & Vascular Institute vascular expert for any ongoing care needed.
If your aortic dissection is discovered before it becomes an emergency, your first visit will be in our outpatient Comprehensive Vascular Clinic.
In most cases, your first visit to UK HealthCare Comprehensive Vascular Clinic is a time of education and introductions. You meet members of your care team and learn about detecting, treating and managing your vascular condition.
Diagnosing vascular disease is a unique process that requires detective work. One of the most important steps toward diagnosis is listening to your story. Your team will ask a lot of questions about your symptoms and medical history. The goal is to gather all the information that can help pinpoint the source of your vascular issue.
Along with discussing your medical history, you will undergo a physical examination. Your care team will then be able to determine the proper next step to take on your diagnostic journey.
When appropriate, your team may prescribe one or more diagnostic tests. These tests typically take place on a different day, and your care team helps schedule them at your convenience. In some cases, you will undergo an ultrasound or other testing as part of your initial visit.
When coming to your first vascular appointment, plan to do the following:
- Arrive early. You may need to fill out paperwork when you arrive. Getting to your appointment early ensures you have time to complete paperwork without feeling rushed.
- Bring a current list of medications or supplements you take. You should also list any previous surgeries, symptoms you’ve experienced and other past health issues.
- Dress comfortably. Working toward a diagnosis takes time. Comfortable clothes help you remain relaxed and attentive throughout your visit. They also make it easier for your team to perform your physical exam.
- Eat and drink normally. In most cases, you won’t undergo imaging or other testing at your first visit. Therefore, there are no dietary restrictions. If specialized testing is part of your first visit, a team member will call to explain any dietary restrictions to follow for your visit. We will also mail you a letter with instructions.
- Have your insurance information on hand. UK HealthCare accepts most insurers, and financial assistance is available.
- Request a loved one to join you. Bring a family member or friend with you to take notes and ask questions you may not think of asking.
Where we are
UK HealthCare Comprehensive Vascular Clinic is located at 740 S. Limestone on the fifth floor, wing D, room L-504.
Where to park
Please park in the parking garage across the street, which is located at 140 Huguelet Drive. For easiest access, drive to the back of the garage and use one of the parking spots reserved for patients of the Comprehensive Vascular Clinic. Once inside, you can access further assistance at the information desk. Wheelchairs are available upon request.
Our vascular care experts help residents of Central Kentucky and beyond improve their vascular health every day. To improve the future of treatment and management of vascular conditions, they also participate in clinical trials.
At any given time, our staff engages in trials for new treatments and devices that provide better treatment and management of vascular conditions. By offering access to clinical trials, we provide access to vascular treatment not available at many other facilities.
If you’re a candidate for an ongoing trial, your care team will discuss the possibility with you.
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