Aortic Dissection: A Silent and Dangerous Cardiovascular Emergency

What is Aortic Dissection?
Aortic dissection is a very serious vascular disease that occurs when the wall of the aorta—the main artery emerging from the heart—tears. When the inner layer of the aorta tears, blood leaks into the tear and progresses along the vessel wall, creating a second channel. This can result in rupture of the vessel or disruption of blood flow to vital organs. In both cases, the risk of death is very high.

What are the symptoms?
The most typical symptom of aortic dissection is sudden, severe pain that often radiates to the back, chest, neck, or abdomen. Patients usually describe this pain as “knife-like” or “tearing.” Other symptoms may include:

• Sudden changes in blood pressure (low or high)

• Shortness of breath

• Fainting

• Weakness in arms or legs

• Stroke-like symptoms

These symptoms appear suddenly and worsen over time. Therefore, emergency medical intervention is vital once symptoms begin.

Who is at risk?
Aortic dissection can occur at any age, but certain individuals are at higher risk. Major risk factors include:

• High blood pressure (hypertension)

• Family history of aortic diseases

• Connective tissue disorders (e.g., Marfan syndrome, Ehlers-Danlos)

• Atherosclerosis (hardening of the arteries)

• Smoking

• Sudden and intense physical exertion

• Pregnancy (especially in the last trimester)

How is it diagnosed?
Diagnosis is made using emergency imaging techniques such as:

• CT angiography

• MR angiography

• Echocardiography (heart ultrasound)

These tests help determine the exact location and extent of the dissection.

How is it treated?
Treatment depends on the type of dissection, typically classified as:

• Type A (near the heart): usually requires emergency surgery.

• Type B (further from the heart): often managed with blood pressure control, though surgery or stenting may be needed if complications arise.

In surgical treatment, the torn portion of the vessel is removed and replaced with an artificial graft. Early intervention is lifesaving.

Can aortic dissection be prevented?
It cannot be fully prevented, but controlling risk factors is highly protective. Especially:

• Regular monitoring and control of blood pressure

• Quitting smoking

• Managing cholesterol and blood sugar levels

• Regular medical check-ups

• Cardiological evaluation for those with a family history of aortic disease

Recognize the symptoms—don’t lose time
Aortic dissection is a race against time. If symptoms appear, calling emergency services (112) and going to the nearest hospital can save lives. Being aware of this silent but dangerous condition may save your life and the lives of your loved ones.

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