What is an Aortic Dissection?

What is an Aortic Dissection?

An aortic dissection is a tear that suddenly occurs between weakened areas of the inner and middle tissue layers of the aorta, the main artery of the body. It is uncommon and usually affects men in their 60s and 70s.

An aorta dissection is a medical emergency and requires immediate treatment. Symptoms of aortic dissection can occasionally be mistaken for another condition, delaying treatment. However, with early detection and prompt treatment, the outcome of aortic dissection can be positive.

Types of Aortic Dissection


Classifications for aortic dissection follow either the DeBakey or Stanford systems, which are based on the dissections’ location in the aorta. Both systems emphasize whether the ascending aorta, the first part of the aorta that extends upwards from the base of the left ventricle, has been affected. 

Stanford classification

Stanford aortic dissections are classified into type A or type B aortic dissections.

  • Stanford type A aortic dissection - The dissection involves the ascending aorta. The tear might extend from the upper part of the aorta down to the abdomen. Symptoms associated with type A aortic dissection are severe, sharp pain that feels like tearing in the chest and back. Shortness of breath is also reported with type A. However, some people exhibit no symptoms.
  • Stanford type B aortic dissection - The dissection does not involve the ascending aorta. Type B dissections could block or reduce blood flow to essential organs such as the kidneys or intestines or cause aorta rupture. In these circumstances, emergent surgery may be needed. Type B dissections are also treated with medications and follow-up appointments in the aortic clinic. Symptoms connected with type B dissections are high blood pressure and severe, sharp pain in the back, chest, and abdomen.
  • Acute aortic dissection - Acute aortic dissection causes sudden and severe pain in the chest, back, or both. Immediate medical attention is required to prevent the aorta from rupturing.
  • Chronic aortic dissection - Symptoms for chronic aortic dissections can go unnoticed for weeks. Shortness of breath, fainting, and sweating are common symptoms of chronic aortic dissection.

DeBakey classification

DeBakey is another classification system for aortic dissection which uses three types:

  • Type I - Begins in the ascending aorta, to the aortic arch, and then descending through the aorta
  • Type II - Begins and remains in the ascending aorta
  • Type III - Begins and remains in the descending aorta

Signs & Symptoms of Aortic Dissections


Symptoms of aortic dissection can mimic the symptoms of a heart attack. Common symptoms can come on suddenly and include:

  • Severe chest pain or upper back pain
  • Severe stomach pain
  • Difficulty breathing
  • Feeling faint or losing consciousness
  • Stroke symptoms including vision problems, difficulty speaking, weakness or paralysis on one side of the body
  • Weak pulse on one side of the body
  • Leg pain with difficulty walking

What Causes Aortic Dissections?


Aortic dissection begins when the cells that make up the aorta start to break down. It can take many years before the weakened section of the aorta finally tears or ruptures.

Doctors believe some people are born with an inherited trait for the propensity of weakened aortic walls. Other people can develop a weakened aorta from years of constant high blood pressure. Eventually, the aortic wall will become too weak, resulting in a tear called aortic dissection.

Causes of Type A aortic dissection

  • Age - Aortic dissection is more common in males over the age of 60
  • High blood pressure for many years can weaken the aortic wall
  • Fatty plaque from high cholesterol can block the artery or break off, causing a blood clot
  • Bulge in the aorta - A blood clot can cause a bulge, which could possibly rupture
  • Aortic valve defects. Certain heart conditions such as bicuspid valve can provoke aortic dissection
  • Genetic disorders - Marfan syndrome and Ehlers-Danlos syndrome are genetic conditions that can affect the structure and strength of the aortic walls

Causes of Type B aortic dissection

  • High blood pressure (Hypertension) - The most common cause of type B aortic dissection is hypertension
  • Age - Men in their 60s and 70s are more prone to aortic dissection
  • Atherosclerosis - Cardiovascular disease causes the arteries to harden, hindering their ability to pump blood
  • Injury - A traumatic injury to the chest can cause aortic dissection
  • Genetic disorders - Certain genetic diseases can predispose a person to aortic

Risk Factors for Aortic Dissection

Risk Factors

Longstanding high blood pressure is the most common risk factor preempting an aortic dissection. After years of pumping harder to circulate blood, the constant stress weakens the aortic walls, causing them to separate or rupture.

Risk factors for aortic dissection include:

Genetic risk factors

  • Congenital heart conditions - Some people are born with heart conditions such as a bicuspid aortic valve (two leaflets instead of three) or Turner syndrome
  • Aortic valve disease - This heart defect is usually present at birth
  • Connective tissue disorders like Marfan syndrome and Ehlers-Danlos syndrome are genetic disorders that are linked to aortic dissection
  • Family history - People with other family members diagnosed with aortic dissection are at a higher risk of developing this condition
  • Hereditary thoracic aortic conditions increase the risk of aortic dissection

Other medical issues or conditions

  • High blood pressure, especially while pregnant
  • Atherosclerosis
  • Aortic aneurysm
  • Vasculitis
  • Traumatic chest injury
  • Emotional stress
  • Increased age


  • Use of amphetamines - Drugs that increase blood pressure, such as cocaine or stimulant drugs increase the risk of aortic dissection
  • Strenuous lifting - Lifting extremely heavy weights can increase the risk for aortic rupture or aortic dissection in people predisposed to this condition



Aortic dissection is a life-threatening condition with dangerous complications. Potential complications depend on where the aortic dissection is located.

Immediate medical attention is needed if you suspect yourself or someone else of experiencing aortic dissection. A delay in treatment could mean death.

Complications that can arise from an aortic dissection include:

  • Death
  • Organ damage
  • Kidney failure
  • Intestinal blockage
  • Heart attack
  • Stroke
  • Paralysis
  • Blood clots in the legs
  • Aortic valve damage or rupture
  • Fluid build up around the heart (cardiac tamponade),between the heart muscle and the sac covering the heart, making it harder for the heart to pump blood



Preventing the development of aortic dissection is not always possible. People are born with heart disorders, connective tissue conditions, or other genetic illnesses that can be risk factors for acquiring an aortic dissection later in life.

Although not entirely predictable, there are health initiatives that can help prevent the development of an aortic dissection.

  • Adopting healthier eating habits
  • Drinking less alcohol
  • Maintaining a healthy blood pressure using medications if dietary changes have not helped
  • Quitting smoking
  • Always wearing a seat belt when driving in a car to avoid a traumatic chest injury
  • Discussing family inherited heart conditions with your doctor, especially if someone has encountered an aortic dissection
Get Care

Trust NewYork-Presbyterian for Aortic Dissection Care

NewYork-Presbyterian has the cardiovascular experts, the experience, and the state-of-the-art facilities to handle the most intricate heart surgeries. We offer diagnosis and treatment for patients from birth through old age.

If you are concerned about your heart health, contact one of NewYork-Presbyterian’s leading cardiologists for an appointment for a consultation.