What’s aortic dissection, the ‘scary’ heart condition that killed Lindsey Graham?

On Saturday (July 10), America lost one of its most prominent lawmakers — Lindsey Graham, the four-time senator from South Carolina. The veteran politician, who was an influential ally of US President Donald Trump and advocate of hawkish US foreign policy, died at the age of 71 from “a brief and sudden illness”.

“On the evening of Saturday, July 11, US Senator Lindsey Graham passed away from a brief and sudden illness,” read a statement. “Senator Graham’s family appreciates prayers at this time and asks for privacy during this incredibly difficult period.”

A day later, on Sunday, as the nation mourned Graham’s demise, preliminary findings from the Medical Examiner of the District of Columbia said the senator died from an “aortic dissection due to arteriosclerotic cardiovascular disease.”

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This has spiked an interest in aortic dissection, with many asking what is this disease and how deadly is it.

What is an aortic dissection?

>> An aortic dissection is a serious condition in which there is a tear in the wall of the major artery carrying blood out of the heart (aorta). As the tear extends along the wall of the aorta, blood can flow in between the layers of the blood vessel wall (dissection). This can lead to aortic rupture or decreased blood flow (ischemia) to organs.

>> Doctors note that there are two types of aortic dissection: The first is a Stanford Type A Aortic Dissection that starts in the first (upper) part of your aorta, closer to your heart. It can be immediately life threatening. It usually requires emergency open-chest surgery to repair or replace the first part of the aorta where the tear started.

>> The other is a Stanford Type B Aortic Dissection, which begins farther down one’s aorta and farther from your heart.

What are the symptoms of aortic dissection?

>> Symptoms of an aortic dissection often occur suddenly and include severe chest or back pain that resembles a heart attack.

>> Dr Roberto Aru, an assistant professor of vascular surgery at Thomas Jefferson University, told ABC News that patients often present with “the worst chest or back pain of their life that is similar to a ripping or stabbing sensation”.

>> Dr Kendra J Grubb, a heart surgeon formerly at Emory University, also concurred that most patients with an aortic dissection complain of excruciating pain. Patients usually describe an excruciating pain, from the chest to the back, “like a knife to the heart,” Dr Grubb said.

>> Additional symptoms can include severe abdominal pain, fainting, shortness of breath, leg pain or weakness, difficulty walking, and stroke-like symptoms such as sudden loss of vision, speech difficulty or weakness.

>> What causes an aortic dissection?

>> An aortic dissection occurs, in most cases, owing to an aortic aneurysm — a bubble in the vessel. Aortic aneurysms can be caused by high blood pressure, atherosclerosis or some rare underlying genetic conditions, like bicuspid aortic valves.

>> Health experts note that in other cases, the stress from constant high blood pressure can weaken the aorta wall. This can lead to a tear and dissection. Dr Jason Lee, chief of vascular surgery at Stanford Medicine, told San Francisco Chronicle that the dangerous condition particularly affects men in their 60s and 70s with high blood pressure, including those in high-stress jobs. A spike in blood pressure related to stress or sometimes intense exercise can lead to aortic rupture, he said.

>> Congenital hard defects as well as a family history of aortic dissection can also increase the risk of contracting this disease. People who smoke are also more prone to developing this condition.

>> According to a report in Cleveland Clinic, powerlifting could increase how quickly aneurysms or dissection develop in people who are prone to them.

How deadly is an aortic dissection?

>> Aortic dissections are very dangerous and life threatening. According to the John Ritter Foundation for Aortic Health, an estimated 20,000 people have an aortic tear each year.

>> Dr Lee notes that half of patients who have aortic dissection die within 48 hours. “It is sad, and it is a sudden thing,” Lee was quoted as saying. “To me, aortic dissection is scary because it can be so sudden.”

>> Other experts also note that its resemblance to a stroke also cause it to be ignored. Moreover, a standard heart attack tests won’t exclude it. As Forbes explained in one report, an EKG, a chest X-ray and blood tests can all look reassuring while the aorta is tearing.

How do you treat an aortic dissection?

>> One can try to avoid an aortic dissection by keeping one’s blood pressure under control and maintaining heart health through diet and exercise.

>> If you have been diagnosed with this condition, treatment will depend on where the tear has occurred.

With inputs from agencies