What is an aortic dissection?
An aortic dissection is a life-threatening emergency in which the inner layer of the aortic wall tears, allowing blood to flow between the layers and separate them. Type A dissections involve the ascending aorta and require emergency surgery — without treatment, mortality is 1-2% per hour in the first 48 hours. Type B dissections involve only the descending aorta and are often managed medically, unless complications develop.
The complete answer.
Aortic dissection presents with sudden, severe chest or back pain often described as "tearing" or "ripping." Risk factors include uncontrolled hypertension (present in 70-80% of cases), connective tissue disorders, bicuspid aortic valve, prior cardiac surgery, and cocaine use. Type A repair involves replacing the ascending aorta and often the aortic root — operative mortality is 15-25% even at experienced centers. Long-term surveillance with CT/MRI is required, as the residual dissected aorta remains at risk.
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