An aortic dissection is a very serious, often times fatal, condition that takes place when the inner layers of the aorta (the body’s largest artery) weaken and tear causing blood to “dissect” the aorta into a false lumen & true lumen (very much like a double barrel shotgun). This can affect the entireity of the blood vessel from the heart to the pelvis, as well as important side branches, which could compromise blood supply to the brain, spinal cord, kidneys, intestine, & lower extremities.

Fortunately, aortic dissection is rare and occurs in about five to 30 people per every one million each year in the United States. The condition is associated with aneurysm (enlarged aorta) and hypertension (high blood pressure).

William’s Experience with Aortic Dissection

55-year-old William Penny has been on a successful journey to improve his health after an annual physical in his 40s indicated he had high cholesterol. He has since adopted a healthy lifestyle and become an avid runner. William revels in taking off on foot any time he is on vacation or traveling for work, exploring a new location through running.

On October 31, William set out for his usual evening run with his wife when close to the end of their route, he felt sudden chest pains. He rested on a park bench thinking he was suffering from indigestion. When the pain didn’t go away, his wife ran home and returned with water and the car to get William home.

The chest pain persisted so later that evening William visited an urgent care clinic which suspected he was suffering from a cardiac episode and referred him right away to St. David’s North Austin Medical Center. After being triaged there, William was ordered to undergo a CT scan. While laying down for the CT scan his chest pain became excruciating.

Things moved quickly after the CT scan revealed an aortic dissection and William underwent surgery with CTVS board certified cardiothoracic surgeon Dr. W. Chance Conner to repair his Type A aortic dissection, the most serious type of tear that occurs in the first part of the aorta near the heart.

He spent a week in the hospital recovering and returned home on November 7.

According to Dr. Conner, William’s prognosis is excellent and he will be able to return to running in the future.

What is the treatment for an aortic dissection?

Treatment for an aortic dissection almost always requires immediate surgery, especially if it is Type A where there is a tear in the first part of the aorta near the heart. A Type B dissection occurs in the more distal portion of the aorta that descends into the abdomen, and surgery or treatment for this is made on a case by case basis.  More on aortic aneurysm/aortic dissection treatment can be found here.

How can you detect an aortic dissection?

Although they typically come on fast and without warning, common symptoms of an aortic dissection may include:

  • Sudden or severe chest or upper back pain that spans from the neck down through the spine
  • A weakened pulse
  • Shortness of breath

Most of the time the chest pain associated with aortic dissection is severe and intense. Patients often have a sense of “doom”. If these symptoms arise patients should call 911 or report immediately to an emergency room. This is especially true for patients with a diagnosis of hypertension and/or aneurysm.

William urges people to not discount any pain in your chest, even if you think it is minor. “I always think about chest pain as people clutching their chest and presumably feeling the pain close to their heart, but mine wasn’t like that,” he recalls.

“I suggest that people open their minds to what chest pain may feel like and take action no matter what if you are experiencing anything in this area that is unusual.”

The most important way you can prevent an aortic dissection is to manage high blood pressure, followed by knowing your family’s history for cardiovascular disease. If you have either of these risk factors, speak with your primary care physician about regular heart health screenings.

For questions about our vascular, cardiac, or thoracic services, please visit ctvstexas.com or call us at (512) 459-8753 to schedule an appointment.

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