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Aortic Dissection

An aortic dissection is a dangerous condition in which a tear develops in the inner layer of the aorta, the large blood vessel branching off the heart.  When an aortic dissection is detected early and treated promptly, your chance of survival greatly improves.

There are two types of aortic dissections are depending on where the tear occurs:

  1. Type A. This is the more common type of aortic dissection. It involves a tear in the ascending portion of the aorta just where it exits the heart or a tear extending from the ascending portion down to the descending portion of the aorta, which may extend into the abdomen.
  2. Type B. This type involves a tear in the descending aorta only, which also may extend into the abdomen.

Causes of Aortic Dissection

Aortic dissection occurs in a weakened area of the aortic wall.  Risk factors may include:

  • Chronic high blood pressure
  • Inherited  conditions associated with a weakened and enlarged aorta, such as Marfan syndrome
  • Traumatic injury to the chest area

The cardiac and vascular surgeons at Johns Hopkins have a long-standing tradition of diagnosing and treating complicated cases like aortic dissection.  Some patients may be candidates for lesser invasive endovascular procedures; however, some may need surgical treatment.

Symptoms of Aortic Dissection

Symptoms of Aortic Dissection are similar to those of a heart attack. They include:

  • Sudden severe chest or upper back pain, or abdominal pain, often described as a tearing, ripping or shearing sensation, that radiates down the back
  • Loss of consciousness (fainting)
  • Shortness of breath
  • Weakness

Examination finding for aortic dissection can mimic many other conditions and diseases.  Diagnostic testing would include:

The treatment for Type A dissections is surgical.  Treatment for Type B is the use of medications to control blood pressure.

Surgical Treatment

Surgical treatment for Type A aortic dissections includes techniques similar to aortic aneurysm surgery.


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