Sen. Lindsey Graham’s sudden death from an aortic dissection has spiked public interest in the condition, with many wondering what it is, who is at risk and whether it can be detected before becoming life-threatening.
“Most people think of aortic dissection as a rare condition, but it’s more common than many realize,” says Joseph Bavaria, MD, Chair of the Department of Cardiac Surgery at Jefferson Health and an international expert on dissection and aortic diseases.
Characterized by a tear in the aortic wall, dissection is a life-threatening medical emergency. It develops suddenly and often without warning, although the underlying aortic disease or weakness that increases the risk of dissection may have been present for years.
Here are three things you should know about aortic dissection:
- Know Your Risk: Men over the age of 60 are most at risk, as are people who smoke, have a family history of dissection or aneurysm, or have a genetic disorder such as Marfan syndrome or Loeys-Dietz syndrome.
“The most significant risk factor is uncontrolled high blood pressure,” Dr. Bavaria says. Despite men being most affected by aortic dissection, it’s common in women too, and they often have worse outcomes than men once treatment becomes necessary. “It’s certainly not something women should dismiss,” he adds.
- There Is No Routine Screening Test for Aortic Dissection: Unlike some cardiovascular conditions, there is no routine screening test for aortic dissection because the tear itself usually occurs suddenly. Instead, physicians look for conditions that increase the risk of dissection — an ascending aortic aneurysm or bicuspid aortic valve disease. “One in approximately 200 people has bicuspid aortic valve disease, which can lead to enlargement of the aorta and increase the risk of future complications,” Dr. Bavaria says. Echocardiogram is typically the first imaging test used to evaluate the aorta. MRI or CT angiography may be recommended when additional evaluation is needed.
- Manage Risk Factors and Understand Treatment Options: The goal is to identify and manage risk factors before an aortic dissection occurs.
- Keep blood pressure under control
- Don’t smoke
- Maintain a healthy weight
- Exercise regularly, but get your physician’s recommendations
- Avoid significant straining or heavy lifting, if you have a risk factor for dissection Physicians monitor a known ascending aortic aneurysm with periodic imaging studies. If it continues to grow and is at risk of tearing, a cardiothoracic surgeon can repair it using a stent or synthetic graft.
Jefferson Health offers an extensive range of open, endovascular and minimally invasive repair procedures to treat ascending aortic aneurysm. “The best thing people can do is know their family history and know their blood pressure results,” Dr. Bavaria says. “If you have high blood pressure or high cholesterol, work with your physician to keep those under control.”