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 is the prognosis for aortic dissection?

For aortic rupture, in which all three layers of the aorta are disrupted, the mortality (death) rate is up to 80% of patients. Fifty percent of these patients die before reaching a hospital.

For type A aortic dissection, the mortality rate remains high, with up to a 30% death rate after surgery.

Type B aortic dissections, treated medically, have an initial death rate of 10%. This compares to a 30% mortality when treated surgically.

Overall, for both types of aortic dissection, the 10-year survival rate is more than 60%.

Can aortic dissection be prevented?

As with any disease involving blood vessels, prevention is key. Controlling high blood pressure, diabetes, cholesterol, and avoiding smoking decreases the risk of all blood vessel disease. Since 70% of patients with aortic dissection have hypertension, controlling high blood pressure (one risk factor) may decrease the risk of this disease.

The use of screening ultrasound to look for abdominal aortic aneurysm is somewhat controversial. The U.S. Preventive Services Task Force recommends a one-time ultrasound screening for males aged 65 to 75 who have ever smoked. There is no recommendation for men who don't smoke. They recommend against screening for women because of the rarity of abdominal aortic aneurysm in women.

Any chest pain should not be ignored and medical care should be accessed immediately by activating the emergency medical services system and calling 9-1-1.

Since the cause of the chest pain may be unknown, giving a baby aspirin to the patient is appropriate, as is providing nitroglycerin (if the patient has been prescribed this medication for chest pain).

Medically reviewed by Robert J. Bryg, MD; Board Certified Internal Medicine with subspecialty in Cardiovascular Disease

REFERENCE:

"Screening for Abdominal Aortic Aneurysm: Recommendation Statement." U.S. Preventive Services Task Force. Feb. 2005.

Medically Reviewed by a Doctor on 11/5/2015
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