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Aortic Dissection

Aortic dissection is a tear in the inner layer of the aorta the major artery carrying blood out of the heart. This potentially life-threatening condition occurs in roughly two out of every 10,000 people.

At UPMC, experts from either the Department of Cardiothoracic Surgery or the Division of Vascular Surgery will handle the treatment of your dissecting aortic aneurysm.

Contact the UPMC Heart and Vascular Institute

To request an appointment, contact the UPMC Heart and Vascular Institute:

What Is Aortic Dissection?

Arteries have three layers. Aortic dissection is a potentially life-threatening condition in which a tear develops in the inner layer of the aorta, the major artery carrying blood out of the heart.

Aortic dissection causes

Causes of a dissecting aortic aneurysm include:

  • Atherosclerosis
  • High blood pressure
  • Degenerative diseases of the aorta.
  • Marfan syndrome
  • Bicuspid aortic valve
  • Injury

Complications of aortic dissection

With an aortic dissection, blood surges through the tear into and along the wall of the aorta, causing the inner and middle layers to separate (dissect).

If the blood-filled channel ruptures through the aortic wall, aortic dissection is usually fatal.

Aortic dissection risk factors

Aortic dissection occurs in approximately two out of every 10,000 people. It can affect anyone, but is most often found in men aged 40 to 70.

Most commonly associated with high blood pressure, an aortic dissection also can result from atherosclerosis.

Other risk factors include:

  • A major chest injury (such as hitting the steering wheel of a car during an accident)
  • A hereditary connective tissue disorder
  • Pregnancy
  • Untreated syphilis

Aortic dissection is a tear in the inner layer of the aorta. Type A aortic dissection is the most common type of dissection and occurs closer to the heart. It can be life threatening and requires immediate surgical itervention to repair or replace the segment of the aorta where the tear began. 

Why choose UPMC for aortic dissection care?

The UPMC Center for Aortic Disease is a specialty program led by cardiothoracic surgeons at UPMC. The center offers a full range of treatments for disorders and diseases affecting the aorta, including aortic dissection. 

Learn More About Aortic Dissection

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Aortic Dissection Symptoms and Diagnosis

Aortic dissection can occur suddenly, and most cases appear in the emergency department as a sudden catastrophic event.

Symptoms of aortic dissection

Like all types of aneurysms, there may be no signs or symptoms of an aortic dissection.

You may experience a sharp, tearing pain in your chest or upper back, or feel pain in your:

  • Shoulder
  • Neck
  • Arm
  • Jaw
  • Abdomen
  • Hips

Diagnosing aortic dissection

Since most aortic dissection cases are diagnosed in the emergency room, the emergency physician will perform a physical exam, and then rapidly proceed with imaging studies, including:

  • Chest x-rays
  • An echocardiogram
  • An aortography
  • CT scans
  • MRI scans 

Learn More About Aortic Dissection Symptoms and Testing

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Aortic Dissection Treatment

Aortic dissection is a life-threatening condition requiring hospitalization, usually in an intensive care unit (ICU).

The condition can be managed if it is diagnosed and treated before the aorta ruptures.

Fewer than half of patients with a ruptured aorta survive; 60 percent of patients treated for aortic dissection are alive 10 years later.

Aortic dissection treatments often include medication or surgical repair, depending on the severity and location of the dissection.

  • Dissection in ascending part of the aorta
    • Immediate, open heart surgery for aortic repair.
    • Stent may be used to replace damaged segment.
  • Dissection in descending part of the aorta
    • If no blood vessels obstructed, treat with medicine first.
    • Medication goals are to lower blood pressure and relieve pain.
  • Damaged aortic valve
    • Valve replacement surgery.
  • Heart arteries involved
    • Coronary bypass surgery.

Our experience in treating aortic dissection

Cardiothoracic surgeons from the Center for Aortic Disease and vascular surgeons from the Division of Vascular Surgery offer treatment for aortic dissection.

Aortic Dissection Education Materials

The UPMC Heart and Vascular Institute offers educational information and videos about aortic dissection and other heart and vascular diseases and treatments.

Many people find these resources helpful in answering their questions about their condition and preparing them for their procedure or diagnostic test.

The links below will open a new browser window.

From our Health Library at