An aortic dissection occurs when a tear in the inner layer of the aorta allows blood to split its wall layers, creating a false channel and risking rupture. Major risk factors include longstanding hypertension, connective-tissue disorders, increasing age, and smoking.
An aortic dissection occurs when the inner layer of the aorta (the main artery supplying the body) becomes damaged. Blood travels in between the walls creating a false passage and tearing the layers of the aortic wall apart.
High blood pressure (hypertension) is a major risk factor for aortic dissection. Over time, the raised blood pressures cause weakness in the aortic wall. Other risk factors include increasing age, disorders of connective tissues and smoking.
Causes of aortic dissection
Aortic dissection is when there is a tear in the wall of your aorta. The tear can occur in an area of the aortic wall that is weak.
You are more at risk of aortic dissection if you:
- have uncontrolled high blood pressure
- have hardening of the arteries
- have an aortic aneurysm
- were born with a defect in your aorta or aortic heart valve
- have had previous heart surgery or a heart procedure
- have a family history of aortic disease
Signs & Symptoms
- Sudden onset of severe, tearing or ripping chest or upper back pain
- Pain radiating to the abdomen, neck, or jaw
- Shortness of breath, sweating, and anxiety
- Dizziness or loss of consciousness
- Unequal pulses or blood pressure between arms
- Signs of shock such as pale, clammy skin and rapid weak pulse2
Emergency Response
Always treat suspected aortic dissection as a life‐threatening emergency. Call emergency services immediately (e.g., 999/911) and be prepared to provide detailed symptom descriptions and vital‐sign observations.
First Aid Steps
- Position the person in a comfortable semi-upright or seated posture to reduce stress on the aorta.
- Loosen any tight clothing around the neck and waist to ease breathing and circulation.
- Reassure and calm the casualty—minimizing movement and anxiety lowers heart rate and blood pressure.
- Administer high-flow oxygen via mask or nasal cannula if trained and equipment is available.
- Monitor airway, breathing, and circulation every few minutes; be ready to perform CPR if the person becomes unresponsive (DRSABCD protocol).
- Do not give any oral medications or fluids.
- Relay all observations (pain quality, vital signs, mental status) to arriving EMS personnel.
Do’s and Don’ts
| Do’s | Don’t |
|---|---|
| Call for emergency medical help immediately | Attempt to realign the person or self-treat blood pressure |
| Keep the person as still and calm as possible | Give food, drink, or oral medications |
| Loosen restrictive clothing around neck and waist | Apply direct pressure to the chest or back |
| Provide high-flow oxygen if trained | Leave the casualty alone |
| Monitor and document vital signs and level of consciousness | Delay summoning professional medical assistance |
Prevention
You can reduce your risk of an aortic dissection by preventing chest injury and taking steps to keep your heart healthy.
- Control blood pressure. If you have high blood pressure, get a home blood pressure measuring device to help you monitor your blood pressure.
- Don’t smoke. If you do smoke, take steps to stop.
- Maintain an ideal weight. Follow a low-salt diet with plenty of fruits, vegetables and whole grains and exercise regularly.
- Wear a seat belt. This reduces the risk of chest injury during a car accident.
REFERENCES
- Aortic Dissection First Aid, https://www.australiawidefirstaid.com.au/resources/first-aid-for-aortic-dissection
- James H Black,Management of acute type A aortic dissection, last updated: Oct 28, 2024. https://www.uptodate.com/contents/management-of-acute-type-a-aortic-dissection
- Ferri FF. Aortic dissection. In: Ferri’s Clinical Advisor 2021. Elsevier; 2021. https://www.clinicalkey.com.
- American Heart Association. Your Aorta: The Pulse of Life. https://www.heart.org/en/health-topics/aortic-aneurysm/your-aorta-the-pulse-of-life. Last reviewed 1/30/2024.
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