Lindsey Graham, a U.S. Senator from South Carolina who served for 23 years, died suddenly on July 11 at age 71. The preliminary report from the medical examiner found that he suffered an aortic dissection, Politico reports, which is a cardiovascular condition.
Aortic dissections occur when the inner layer of tissue in the aorta, which carries blood from the heart to the rest of the body, ruptures. This allows blood to rush into the space between the lining of the blood vessel and the outer parts of the wall, peeling the lining back and weakening the whole structure.
Wear-and-tear on the arteries is a major culprit, says Dr. Graham Cooper, a consultant cardiac surgeon in the U.K. and a trustee of the Aortic Dissection Charitable Trust. He notes that dissections may become more prevalent in the U.K. as the population ages. Prevention involves keeping blood pressure down and quitting smoking, but it’s also important that families where someone has experienced a dissection talk about it with a medical practitioner, as some cases are linked to genetic mutations that may be passed down. People with Marfan syndrome, for instance, are at a higher risk for aortic dissections.
—Anastasia Usenko—Getty ImagesWhat are the symptoms of aortic dissection?
“The typical symptoms are sudden onset of chest pain that can radiate to the back or the neck,” says Cooper. “That pain can come and go, or it can be there very strongly and then fade within minutes or hours, depending on how the dissection progresses.”
Symptoms aren’t limited to chest pain. They can also include abdominal pain or symptoms that resemble those of a stroke or a heart attack.
Simon Jones is a survivor of the condition and trustee of the charity Aortic Dissection Awareness. In May 2020, when he was 49, Jones started to feel abdominal pain that was so persistent that after two hours, his wife called an ambulance. At the hospital, his doctor ordered a CT scan, which is the only way to rule out a dissection when someone has sudden abdominal pain. When the dissection popped on the screen, the doctors knew it wasn’t kidney stones or appendicitis or any of the other usual suspects for these types of symptoms.
For many people, aortic dissection is fatal. The most common type is lethal in about half of patients, and death is almost instantaneous. “The dissection weakens the wall of the aorta,” Cooper explains. “It ruptures, blood escapes into the sac that surrounds the heart, and that stops the heart working—and they have a cardiac arrest.”
Aortic dissections are rarer than some other forms of heart disease, says Dr. Amitava Banerjee, cardiologist and professor of clinical data science at University College London. Still, in the U.K., more people die of aortic dissection each year than die in road traffic accidents, says Jones. In the U.S., about 13,000 people die from aortic dissection every year.
How do you treat an aortic dissection?
For most people who are still alive when their dissection is spotted, the primary treatment is emergency open-heart surgery to remove the aorta and replace it with a tube, says Banerjee.
Aortic dissections are not always recognized immediately. Without a CT scan, there is no way to know that it’s not something more benign causing the pain. Jones feels he owes his survival to an awareness campaign, ThinkAorta, that the charity for which he is now a trustee had circulated among doctors, including the one who saw him at his local hospital. “She'd seen the posters," he says, "and she had a hunch.”
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