Aortic Dissection

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What are the signs and symptoms of aortic dissection?

  • Pain is the most common symptom of aortic dissection and is often described as tearing or ripping and often begins suddenly. If the aortic dissection occurs in the chest, the pain is usually centered in the chest and radiates directly into the upper back. If the dissection occurs in the abdominal aorta, the pain may occur in the mid back or low back and radiate to the flanks.
  • There may be associated nausea, sweating, shortness of breath, and weakness.
  • The patient may pass out (syncope).
  • Other symptoms may be related to the location of the dissection within the aorta and whether it affects some of the branch arteries and occludes their blood supply. For example, if an artery that supplies blood to the brain is involved, there may be signs of stroke. Or if the dissection affects the anterior spinal artery and blood supply to the spinal cord, the patient may present with paraplegia.
  • The coronary arteries that supply blood to the heart begin at the origin of the aorta at the aortic valve. If the coronary arteries are involved, the aortic dissection may cause a heart attack (myocardial infarction) as its presenting symptom.
  • The patient may present with congestive heart failure with fluid building up in the lungs. If the aortic dissection involves the aortic valve and causes it to fail, blood flows back into the heart with each beat and causes blood flow to back up into the lungs.
  • The pain of aortic dissection can be confused with that of heart attack, but can sometimes be distinguished because of its sudden onset, potentially normal electrocardiogram, and abnormal findings on chest X-ray.
  • The pain of an abdominal aortic dissection can be confused with the pain caused by a kidney stone. The diagnosis is made when a CT scan looking for the kidney stone reveals an aneurysm instead.
  • The patient may also have a sense of impending doom.
Medically Reviewed by a Doctor on 11/5/2015
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