Patient & Family FAQs

The aorta is the largest blood vessel in the body. It is an artery which carries blood from the heart and descends through the chest and the tummy (abdomen). Many other arteries branch off the aorta to supply blood to all parts of the body. At about the level of the hips, the aorta divides into two arteries, one going to each leg.

Aortic dissection is a life-threatening condition that results when bleeding occurs between the innermost layers of the wall of the aorta – the body’s largest artery. This is  a serious medical emergency and needs urgent treatment. The treatment for aortic dissection can include a major operation to repair the wall of the aorta, as well as medicines to reduce blood pressure. Aortic dissection is often fatal, but early diagnosis and treatment can greatly improve survival.

Type A

This involves a tear that starts in the part of the aorta where it arises from the heart (the ascending aorta). The tear may extend all the way into the descending aorta, including the tummy (abdomen).

Type B 

This involves a tear that starts in the descending aorta, anywhere below the artery that branches off to supply blood to the left arm. The tear may also extend into the abdomen. A Type B dissection does not involve the ascending aorta.

Aortic dissection symptoms can vary in each individual and can be similar to those of a heart attack in some people. 

Pain is the number one symptom

• Neck, back, chest or abdomen
• Numbness or weakness in any limbs
• History of collapse

Pain characteristics can be: 

• Maximal in seconds
• Migratory & transient
• Pain can be sharp, tearing and ripping
• Remember diagnostic warning - Chest x-ray, ECG, ultrasound & blood tests can be normal and must not be taken as the only factor in diagnosis.

The symptoms may be very similar to those of a heart attack. The pain can start suddenly and is often described as a tearing or ripping feeling often spreading to the neck or down the back.

Aortic dissection can present with sudden onset chest, back, or abdominal pain that is severe in intensity. The pain is sometimes described  as ripping or tearing, but it can settle or move around. The condition is much more common in patients with a high-risk condition (such as Marfan, vascular Ehlers-Danlos or Loeys-Dietz syndrome) or a family history of aortic disease.

Treatment depends on the Type and location of the aortic dissection.

Type A is a tear that starts in the part of the aorta that arises from the heart. This tear can extend into the descending aorta and abdomen. The risk is very high, and almost always requires immediate surgery to repair the aorta and possibly also replace the aortic valve.

Type B is a tear that starts in the descending part of the aorta. It can extend into the abdomen. Type B dissection is a medical emergency but doesn’t always require immediate surgery. Stenting, where a device is inserted via the groin or arm and used to re-line the affected part of the aorta, is increasingly used in Type B dissection. Doctors may be able to keep the condition under control just with appropriate medical management, including lifestyle advice and medicines.

Non-A, Non-B is a tear which starts in the arch of the aorta, beyond where a Type A dissection would start, but before a Type B dissection would start. The dissection can extend into the descending aorta and the tummy (abdomen). These dissections sometimes require surgical replacement of the aortic arch, which is a major operation. Sometimes, they can be treated with a ‘stent’ that is inserted via the groin or arm and used to re-line the affected part of the aorta.

All people who have aortic dissection (including those treated surgically) will have to take medication to control their blood pressure, usually for the rest of their lives. The medication helps reduce stress on the aorta. Other medicines are also prescribed.

Please look at our family and carers page. Also, as a patient or relative, you can join our Aortic Dissection UK Buddies Facebook group.