Lifesaving facts about aortic dissection

This article was updated in July 2026.

Aortic dissection occurs when weakened layers of the aorta — the body's main artery — pull apart or tear, trapping blood between layers. This further weakens the aorta and may cause it to rupture.

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"An acute aortic dissection is a very lethal condition," says Bo Yang, M.D., a cardiac surgeon at the University of Michigan Frankel Cardiovascular Center.

Aortic dissection is rare, affecting about 6 in every 100,000 people each year.

But knowing the symptoms and risk factors — a genetic predisposition in particular — can be lifesaving.

There are two types of aortic dissection. Type A involves the ascending aorta and is treated surgically by removing the most vulnerable dissected aorta and redirecting the blood flow into the original lumen of the aorta. The aorta is replaced with a graft, or synthetic tube.

If left untreated, about 33 percent of acute type A patients die within the first 24 hours, and 50 percent die within 48 hours.

"This is the more dangerous type of the acute aortic dissection," Yang says.

Type B involves the descending aorta and is typically managed with blood pressure medication or stent graft if needed if there is no other related complication. Without treatment, complications include a decrease in blood flow to the kidneys, bowels, spinal cord and other body parts and the possibility of a rupture, and becomes chronic aortic aneurysm. 

Symptoms of aortic dissection

Each type of aortic dissection has different symptoms.

The pain involved in acute type A dissection may feel as though something inside the chest is tearing or ripping, Yang says.

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"Immediate medical attention is critical if a person feels sudden, excruciating pain in the chest that radiates to the upper back," Yang says.

And the condition doesn't discriminate by age: "When a person age 50 or younger experiences extreme chest pain, there is a high suspicion of an aortic dissection until proven otherwise," Yang adds.

By comparison, type B aortic dissection often causes back pain, pain in the stomach or mid- or lower back with leg weakness. People experiencing these symptoms should also see a doctor right away.

If someone in your family has suffered an aortic dissection, especially someone under the age of 50, all biological family members need to be evaluated.

Genetics and aortic dissection

Family history is a valuable predictor of a type A aortic dissection.

"If someone in your family has suffered an aortic dissection, especially someone under the age of 50, all biological family members need to be evaluated," Yang says.

This is crucial if the patient is also diagnosed with a genetic disorder such as Marfan, Loeys-Dietz or Ehlers-Danlos syndromes or PRKG1 mutations, which increase the risk of thoracic aortic aneurysms or acute aortic dissections.

SEE ALSO: Don't Second-Guess Yourself, Aortic Dissection Survivor Says

"If anyone tests positive for pathogenic gene mutations, they should be closely monitored and should seriously consider a prophylactic operation, especially if they have an aortic root aneurysm," Yang says.

This precautionary surgery, known as a valve-sparing aortic root replacement or the David procedure, involves replacing the aortic root and ascending aorta.

Although invasive, the surgery is intended to be lifesaving, Yang says. Patients also avoid the need for lifelong anticoagulation therapy, thus improving their quality of life.

It’s important to mention to your doctor if you had a sudden, unexpected death in the family. 

“There is a tendency to think the cause of sudden cardiac death is always heart attack, but it could be due to aortic dissection,” said Kim A. Eagle, M.D., cardiologist at the U-M Health Frankel Cardiovascular Center.

“We work hard in cardiovascular disease prevention to unexpected deaths and determine what steps can and should be taken to protect family members.”

Other aortic dissection risk factors

Genetics aren't the only risk factor for aortic dissection.

Smokers and hypertension, or high blood pressure, also increase the risk of aortic dissection. Around 4 in 5 patients who undergo aortic dissection have a history of hypertension. Aortic aneurysm, an enlargement of the aorta, is another. It's considered a silent killer because people often don't experience symptoms, such as severe chest pain — or they experience them when it's too late.

Nearly half of these people die before seeking medical treatment, Yang notes.

One place an enlarged thoracic or abnormal aorta can show up in on a coronary artery calcium test, a scan to determine the risk of heart disease.  “While the test is not focused on the aorta, it can provide valuable information about the risk for issues such as aortic aneurysm or dissection,” Eagle said.

MI-AORTA and Michigan Medicine:

In 2022, the MI-AORTA Program was established with generous donor support and plays a key role in advancing and expanding our highly regarded aortic disease clinical practice, training and research efforts. Through this support, it helps fuel the growth of a world-renowned comprehensive aortic program that treats conditions across the aorta — from root to aortic bifurcation — using open and endovascular techniques.