Acute Aortic Syndrome

What is acute aortic syndrome?

Acute aortic syndrome is a term for conditions that affect your thoracic and abdominal aorta. The aorta is the large artery that carries blood away from your heart. The thoracic and abdominal aorta are the sections of the aorta in your chest and abdomen.

Acute aortic syndromes usually require urgent treatment, and many people need surgery. Without treatment, acute aortic syndrome can be life-threatening.

What are the types of acute aortic syndromes?

There are three types of acute aortic syndromes:

• Acute aortic dissection occurs when you have a tear in your aortic wall. It’s the most severe type of acute aortic syndrome.
• Intramural hematoma occurs when the blood vessels in the aorta rupture and blood collects in your aortic wall.
• Penetrating atherosclerotic ulcer is a lesion in the aortic wall.

What are the symptoms of acute aortic syndrome?

The most common symptom of acute aortic syndrome is severe, sudden chest pain. You may also experience:

• Abdominal pain.
• Back pain.
• Fainting.
• Low or no pulse in your legs or feet.

What causes acute aortic syndrome?

The most common cause of acute aortic syndrome is unmanaged high blood pressure (hypertension). Other causes may include:

• Aortic aneurysm.
• Aortic valve defects.
• Plaque buildup and narrowed arteries (atherosclerosis).

Who is most likely to get acute aortic syndrome?

You’re more likely to develop acute aortic syndrome if you have:

• Aortic aneurysm.
• Aortic coarctation.
• Bicuspid aortic valve disease.
• Certain genetic disorders, such as Marfan syndrome, Turner syndrome or Ehlers-Danlos syndrome.
• High blood pressure.

Other risk factors may include:

• Age: Acute aortic syndrome is more common in people over 60.
• Drug use: People who use cocaine are more likely to develop acute aortic syndrome.
• High-intensity strength training: Heavy weightlifting and other resistance training may increase your risk of acute aortic syndrome.
• Pregnancy: Sometimes, people with no other risk factors or health problems develop acute aortic syndrome while pregnant.
• Sex: Acute aortic syndrome is more common in men and people assigned male at birth (AMAB) than women and people assigned female at birth (AFAB).

How is acute aortic syndrome diagnosed?

Healthcare providers use tests to diagnose acute aortic syndrome, including:

• CT scan is the gold standard for viewing your aorta’s structure, function and blood flow.
• Chest X-ray to view your heart’s structure and the surrounding organs.
• Coronary angiogram to assess your heart’s blood vessels and how blood flows through your heart.
• Electrocardiogram (EKG) to evaluate your heart’s electrical signals.
• Transthoracic echocardiogram to look at your heart’s chambers, valves and blood vessels.

How is acute aortic syndrome treated?

The ascending aorta is the first upward portion of the aorta closest to your heart. Acute aortic syndrome in your ascending aorta requires emergency surgery. The surgeon often repairs the damage in the aorta by removing the damaged portion and replacing it with a tube made out of human-made material (synthetic graft). In severe cases, you may have an aortic valve replacement.

The descending aorta is the downward portion that connects to your arteries. Blood pressure medications can treat acute aortic syndrome in your descending aorta. You may take beta blockers or vasodilators.

How can I reduce my risk of acute aortic syndrome?

You can reduce your risk of acute aortic syndrome by practicing healthy habits, such as:

• Achieving and maintaining a weight that’s healthy for your age, sex and body type.
• Controlling your blood pressure.
• Following your healthcare provider’s instructions to manage any underlying health conditions.
• Quitting smoking.

What is the outlook for acute aortic syndrome?

Acute aortic syndrome can be life-threatening and emergency surgery is often needed. The sooner you receive treatment, the better your chances of a favorable outcome. The survival rate is higher for intramural hematoma and penetrating atherosclerotic ulcer than for people with acute aortic dissection.

You’ll need follow-up treatment to ensure your aorta doesn’t leak or form an aneurysm. You’ll also need to closely monitor your blood pressure long-term.

What questions should I ask my healthcare provider?

If you have acute aortic syndrome, you may also want to ask your healthcare provider:

• What’s the most likely cause of my symptoms?
• I have an underlying heart condition; what’s my risk of developing acute aortic syndrome?
• What are the signs of acute aortic syndrome?
• What are the treatment options for acute aortic syndrome?
• What follow-up care do I need after acute aortic syndrome treatment?

What is the most common presenting symptom reported in people with acute aortic dissection?

The most common symptom in people with acute aortic dissection is sudden, severe chest pain. The pain may radiate to your abdomen or back.

A note from Cleveland Clinic

Acute aortic syndrome is a term for urgent conditions that affect your thoracic or abdominal aorta. Often, these conditions require emergency surgery. For many people, the first sign of acute aortic syndrome is sudden chest pain that may radiate to the back or abdomen. You’re more likely to develop acute aortic syndrome if you have another heart condition, unmanaged blood pressure or certain genetic diseases.