Following the sudden death of U.S. Senator Lindsey Graham of South Carolina, widespread news reports indicate he suffered from an aortic dissection, a medical emergency that can be rapidly fatal if not diagnosed and treated promptly, according to the American Heart Association.
An aortic dissection is a tear in the inner layer of the aorta, the body's largest artery, which carries oxygen-rich blood from the heart to the rest of the body. Blood surges through the tear, causing the layers of the aortic wall to separate. Aortic disease can occur when the aortic wall is weakened and either bulges (aneurysm) or tears (dissection). A tear in the wall allows blood to pass through and creates a flap that can lead to complications including heart attack, bleeding, or rupture through the back of the wall.
Symptoms may include sudden, severe chest pain; back pain; neck or jaw pain; and feeling faint, weak, or short of breath. These symptoms can mimic other cardiovascular emergencies, making rapid diagnosis essential. A ruptured aneurysm or severe aortic dissection can be immediately fatal, but prompt diagnosis and treatment can be lifesaving.
According to American Heart Association volunteer president Manesh Patel, M.D., FAHA, “Aortic dissection, a life-threatening disorder, is more common in men than women, with an estimated incidence of 5 to 30 people per million. Most people experience a dissection between the ages of 50-70. Risk factors include atherosclerosis and high blood pressure. There are some genetic disorders of connective tissue that lead to aneurysms and aortic disease in younger adults.” Patel is also chief of the division of cardiology at Duke University School of Medicine.
The 2022 American Heart Association/American College of Cardiology Guideline for the Diagnosis and Management of Aortic Disease emphasizes rapid recognition and treatment of acute aortic syndromes, family screening including genetic testing and imaging for first-degree relatives of patients with certain aortic aneurysms or aortic dissection, and consistent imaging and surveillance practices. The full guideline is available at 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease.
The American Heart Association notes that people with risk factors including high blood pressure, tobacco use, or family history of aortic aneurysms or dissections should discuss aortic aneurysm risk and screening with their physicians. The Association receives more than 85% of its revenue from sources other than corporations, and overall financial information is available here.
