Dissecting Aneurysm: Symptoms, Causes, Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Rakesh Kumar Kodakandla , CTVS Cardiothoracic and Vascular Surgeons

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Dissecting Aneurysm, commonly referred to as aortic dissection, is a life-threatening condition in which a tear develops in the inner layer of a major artery, allowing blood to separate the layers of the vessel wall. It most often affects the aorta and can rapidly disrupt blood flow to vital organs. Symptoms typically include sudden, severe chest or back pain and require immediate medical attention. Early diagnosis and emergency treatment are essential to prevent serious complications and improve survival.

What are the Types of Dissecting Aneurysm?

Aortic dissection is commonly classified using the Stanford classification, which guides treatment decisions.

Stanford Type A Aortic Dissection

This type involves the ascending aorta and is a surgical emergency because of its high risk of fatal complications.

Involves the ascending aorta
Requires emergency surgery
Higher risk of rupture and death

Stanford Type B Aortic Dissection

This type affects the descending aorta and may be managed with medications or endovascular procedures depending on the severity.

Involves the descending aorta
Often treated with blood pressure control
May require endovascular repair if complications develop

What are the Symptoms and Warning Signs of a Dissecting Aneurysm?

Symptoms usually begin suddenly and can rapidly become life-threatening. The type and severity of symptoms depend on the location and extent of the dissection.

Anyone with sudden severe chest or back pain should seek emergency medical care immediately.

Common Symptoms

Sudden severe chest pain described as tearing or ripping
Severe upper back pain
Pain that spreads to the neck, jaw, abdomen, or legs
Shortness of breath
Sweating
Fainting (syncope)

Severe Symptoms

Stroke symptoms such as weakness or difficulty speaking
Heart attack
Loss of consciousness
Shock due to severe blood loss
Kidney or intestinal ischemia
Aortic rupture causing sudden death

What are the Common Causes and Risk Factors of a Dissecting Aneurysm?

Aortic dissection develops when the aortic wall becomes weakened and tears under the force of blood flow. Long-standing high blood pressure is the most common underlying cause.

Controlling blood pressure and treating underlying cardiovascular conditions can help reduce the risk.

Causes

Tear in the inner layer of the aorta
Chronic high blood pressure
Weakening of the aortic wall
Inherited connective tissue disorders

Risk Factors

Hypertension
Atherosclerosis
Marfan syndrome, Loeys-Dietz syndrome, or Ehlers-Danlos syndrome
Bicuspid aortic valve
Known aortic aneurysm
Advanced age
Smoking
Previous cardiac or aortic surgery

When to See a Doctor for a Dissecting Aneurysm?

Aortic dissection is a medical emergency. Anyone with sudden, severe chest, back, or abdominal pain should seek emergency medical care immediately. Definitive treatment is provided by a Cardiologist and CTVA Cardiothoracic and Vascular Surgery.

You should seek emergency medical care if you experience:

Sudden tearing chest or back pain
Pain spreading to the neck, jaw, abdomen, or legs
Sudden shortness of breath or fainting

Call emergency medical services immediately if you:

Develop stroke symptoms such as facial drooping or weakness
Lose consciousness or become confused
Experience severe chest pain with signs of shock or collapse

These symptoms may indicate an acute aortic dissection requiring immediate life-saving treatment.

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How is a Dissecting Aneurysm Diagnosed?

Rapid diagnosis is essential because aortic dissection is a life-threatening emergency. Imaging studies are used to confirm the diagnosis and determine the location and extent of the dissection.

Immediate evaluation allows prompt treatment and improves survival.

Diagnostic Methods

Medical history and physical examination
Blood pressure measurement in both arms
Electrocardiogram (ECG) to exclude heart attack
Computed Tomography (CT) angiography
Magnetic Resonance Imaging (MRI) angiography when appropriate
Transesophageal echocardiography (TEE)
Chest X-ray

What are the Treatment Options for a Dissecting Aneurysm?

Treatment depends on the type and severity of the dissection. The goals are to stabilize the patient, reduce stress on the aorta, and repair the damaged vessel when necessary.

Emergency treatment greatly improves the chances of survival.