Vascular Condition
Arterial Dissections
An arterial dissection occurs when a tear develops in the inner layer of an artery wall, allowing blood to enter between the layers and create a false lumen. This can dramatically alter blood flow through the vessel, leading to ischaemia in the organs or limbs supplied. Aortic dissection is a life-threatening emergency; peripheral dissections may also cause significant limb or organ compromise.
Symptoms
- Sudden severe tearing or ripping pain in the chest, back, or abdomen
- Pulse or blood pressure difference between arms
- Arm or leg pain with reduced pulses
- Neurological symptoms — stroke, weakness, or confusion
- Abdominal pain with signs of visceral ischaemia
- Hypertension or shock depending on the dissection type
Causes & Risk Factors
- Long-standing high blood pressure (hypertension)
- Connective tissue disorders such as Marfan syndrome or Ehlers-Danlos syndrome
- Atherosclerosis and degeneration of the artery wall
- Trauma or blunt force injury
- Bicuspid aortic valve or other structural cardiac abnormalities
Treatment
Management depends on the type and extent of dissection. Aortic dissections may be managed with blood pressure control alone (Type B), or may require emergency open or endovascular repair (Type A). Peripheral arterial dissections causing ischaemia are treated endovascularly or surgically.
Recovery & Aftercare
Recovery varies widely depending on the dissection type and treatment. Lifelong blood pressure control and imaging surveillance are essential. Patients with connective tissue disorders require regular long-term follow-up.
Frequently Asked Questions
Aortic Type A dissection is a surgical emergency requiring immediate intervention. Type B and peripheral dissections may be managed more selectively, but all require urgent specialist assessment.
An aneurysm is an abnormal widening of an artery. A dissection is a tear in the artery wall creating a false lumen. The two can coexist.
When to Seek Medical Advice
- Sudden severe chest, back, or abdominal pain
- Symptoms of limb ischaemia after a trauma
- Any neurological symptoms with chest pain
- Known connective tissue disorder with new vascular symptoms