This condition is commonly caused by weakening of the artery wall due to high blood pressure. Other causes may include:

• An injury, such as from a car crash.

• A complication from heart surgery or from a diagnostic procedure called coronary catheterization.

• Weakness of the artery wall due to birth defects or genetic problems that affect the connective tissues, such as Marfan syndrome.

The following factors may make you more likely to develop this condition:

• Having certain medical conditions, such as:

  • High blood pressure (hypertension).

  • Hardening and narrowing of the arteries (atherosclerosis).

  • A condition that causes inflammation of blood vessels, such as giant cell arteritis.

• Having two cusps in the aortic valve instead of three (bicuspid aortic valve).

• Having a bulge in the wall of the aorta (aortic aneurysm).

• Being male.

• Being pregnant.

• Being older than age 60.

• Using stimulants such as cocaine or methamphetamine.

• Smoking.

• Lifting heavy weights or doing other types of strength training, also called high-intensity resistance training.

Signs and symptoms of aortic dissection start suddenly. The most common symptoms are:

• Severe, sharp chest pain that may feel like tearing or stabbing.

• Severe pain that spreads to the back, neck, jaw, abdomen, or down the legs.

• Severe pain between the shoulder blades in the back.

Other symptoms may include:

• Trouble breathing.

• Dizziness or fainting.

• Sudden weakness on one side of the body.

• Nausea or vomiting.

• Trouble swallowing.

• Coughing up blood.

• Vomiting blood.

• Clammy skin.

This condition may be diagnosed based on:

• Your symptoms and a physical exam. This may include:

  • Listening for abnormal blood flow sounds (murmurs) in your chest or abdomen.

  • Checking your pulse in your arms and legs.

  • Checking your blood pressure to see whether it is low, or whether there is a difference between the measurements from your right arm and left arm.

  • Comparing your heart beat to your pulse in your arms and legs.

• Electrocardiogram (ECG). This test measures the electrical activity in your heart.

• Chest X-ray.

• CT scan.

• MRI.

• Echocardiogram. This uses sound waves to make images of your heart.

• Transesophageal echocardiography. This test takes images of your heart through the esophagus.

• Blood tests.

It is important to treat aortic dissection as quickly as possible. Treatment may start as soon as your health care provider thinks that you have aortic dissection. Treatment depends on where the dissection is, how severe it is, and your overall health. Treatment may include:

• Medicines to lower your heart rate and blood pressure.

• Surgery to repair your aorta using artificial material (syntheticgraft).

• A procedure to insert a stent-graft into the aorta (endovascular procedure). During this procedure:

  1. A long, thin tube (stent) is inserted into an artery near the groin (femoral artery).

  2. The stent is moved up to the damaged part of the aorta.

  3. The stent is opened to help improve blood flow and prevent future dissection.

Activity

• You may have to avoid lifting. Ask your health care provider how much you can safely lift.

• Avoid activities that could injure your chest or abdomen. Ask your health care provider what activities are safe for you.

• After you have recovered, try to stay active. Ask your health care provider what activities are safe for you after recovery.

• Enroll in cardiac rehabilitation. This is a program that helps to improve your health and well-being. It includes exercise training, education, and counseling to help you recover.

Lifestyle

• Eat a heart-healthy diet, which includes lots of fresh fruits and vegetables, low-fat (lean) protein, and whole grains. Limit unhealthy fats. Eat more healthy fats such as avocados, eggs, and oily fish.

• Work with your health care provider to treat any other conditions that you may have, such as obesity, high blood pressure, or diabetes.

• Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.

• Do not use illegal drugs, especially stimulants such as cocaine or methamphetamine.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.

• Talk with your health care provider about how to manage stress.

• Keep all follow-up visits. This is important.

These symptoms may be an emergency. Get help right away. Call 911.

• Do not wait to see if the symptoms will go away.

• Do not drive yourself to the hospital.