Following the sudden death of U.S. Senator Lindsey Graham of South Carolina, widespread news reports indicate he suffered from an aortic dissection. An aortic dissection is a tear 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 aortic wall. This condition is a medical emergency that can be rapidly fatal if not diagnosed and treated promptly, according to the American Heart Association.
The aorta carries oxygen-rich blood from the heart to the rest of the body. Aortic disease can occur when the aortic wall is weakened, leading to a bulge (aneurysm) or a tear (dissection). When the wall tears, blood passes through and 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 may include sudden, severe chest pain, back pain, neck or jaw pain, and feeling faint, weak, or short of breath. These symptoms can mimic other cardiovascular emergencies, making rapid diagnosis essential. A ruptured aneurysm or severe aortic dissection can be immediately fatal, but prompt diagnosis and treatment can be lifesaving.
American Heart Association volunteer president Manesh Patel, M.D., FAHA, noted that aortic dissection is more common in men than women, with an estimated incidence of 5 to 30 people per million. Most people experience a dissection between the ages of 50 and 70. Risk factors include atherosclerosis (hardening of the arteries), high blood pressure, and certain genetic disorders of connective tissue that lead to aneurysms and aortic disease in younger adults. Dr. Patel emphasized that individuals with risk factors such as high blood pressure, tobacco use, or a family history of aortic aneurysms or dissections should 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 aortic dissection, and consistent imaging and surveillance practices. The American Heart Association can connect reporters with experts to discuss what an aortic dissection is and why it can be deadly, risk factors and warning signs, advances in diagnosis and treatment, the importance of family history and screening, and recommendations from the guideline.
For more information, the Association provides additional resources, including the 2022 news release on the guideline and the 2022 consumer news story. The complete guideline is available at 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease.
