A sharp and sudden chest pain could be caused by any number of issues, such as a heart attack.
Another possibility, although extremely rare, is an aortic dissection.
Aortic dissections are estimated to occur in about 5 to 30 people per every one million in the United States each year.
What is aortic dissection?
An aortic dissection occurs when the inner layer of the aorta (the largest artery in the body) becomes weak and tears, or dissects, causing blood to spill out into the heart. It is a very serious condition which can lead to severe complications, or even death.
There are two types of aortic dissections:
- Type A: a tear in the upper part of the aorta or where the aorta exits the heart (this is the most serious type)
- Type B: a tear in the lower part of the aorta, or where it extends into the abdomen
What are symptoms of aortic dissection?
Symptoms of aortic dissection include sudden or severe chest or upper back pain that spans from the neck down through the spine, a weakened pulse, or shortness of breath.
Is aortic dissection always fatal?
Aortic dissection can prove fatal if not treated immediately, as it can restrict blood flow to vital organs resulting in heart attack, stroke, kidney or bowel damage and paraplegia.
If aortic dissection is suspected, a definitive diagnosis is needed right away along with swift action such as surgery in order to repair the tear.
How can surgery treat an aortic dissection?
For dissections involving the ascending aorta and arch, emergency surgery is almost always necessary.
“The procedure involves the use of cardiopulmonary bypass and circulatory arrest to allow for replacement of the ascending aorta and all or part of the aortic arch,” explains CTVS board-certified cardiothoracic surgeon Dr. Mark Felger.
“These are major operations with significant risk.”
However, for dissections of the descending thoracic aorta, surgical decisions are based on the presence of malperfusion (or malfunction) of the end organ such as the gut or kidneys.
“These dissections can often be treated with a percutaneous approach that does not require bypass surgery,” says Dr. Felger.
Who is at risk?
People with high blood pressure, atherosclerosis, a personal or family history of aneurysms, a diagnosis of connective tissue disorder, or individuals with congenital aortic valve disease have the highest risk for suffering an aortic dissection.
Preventing Aortic Dissection
“The primary driver for aortic dissection is uncontrolled hypertension, and individuals with hypertension should have regular follow-up with their primary care physician,” urges Dr. Felger.
He also suggests keeping a daily log of your blood pressure and scheduling regular check-ups with heart specialists if you are at risk for cardiovascular disease.