South Carolina Sen. Lindsey Graham’s sudden illness and death late Saturday was attributed to aortic dissection, according to a preliminary report from the medical examiner.
The condition has a high fatality rate and is most often traced to high blood pressure, which can be controlled with a doctor’s help, D.C.-area cardiologists told WTOP.
“An aortic dissection is a sudden tear in the lining of the aorta,” said Dr. Brian Choi, professor of medicine and radiology at The George Washington University.
“As blood gets forced into that tear, it tears apart the layers of the artery. It can block blood flow or even can cause a fatal rupture,” he said. “It can be turned into a very catastrophic event.”
Graham was treated at The George Washington University Hospital, but Choi, whose specialty includes noninvasive cardiovascular imaging, was not involved in Graham’s care.
“Someone can look completely fit and be active and there is a disaster brewing inside their chest,” Choi said.
The symptoms of an aortic tear include sudden and severe chest pain, back pain, jaw pain, shoulder pain or abdominal pain.
“If it comes on suddenly and particularly if it’s unlike anything you’ve felt before, it should be treated like a medical emergency and you should call 911,” said Dr. David Ain, a cardiologist with the American Heart Association and Kaiser Permanente in Gaithersburg, Maryland.
Choi called it a “time-critical emergency.”
“Survival depends entirely upon recognizing that it is occurring and getting emergency surgical intervention as intervention as quickly as possible,” he said.
Nearly half of aortic dissection patients don’t survive the first 48 hours without emergency surgery.
“Even if you get to surgery the mortality rate is very high,” Choi said. “About one quarter of patients don’t survive the hospitalization.”
Addressing the ‘silent killer’
In most cases, the main causes can be spotted through regular screenings.
“The most common underlying problem is longstanding high blood pressure. This places stress on the wall of the aorta over many years,” Ain said.
“We call it, in our specialty, the silent killer,” Choi said.
In some patients, aortic dissection can also be traced to a connective tissue disorder.
“The most common one being Marfan syndrome, which can cause a weakness in the blood vessel that can also result in a similar kind of tear,” Choi said.
Family history is another risk factor.
“If a close relative has an aortic aneurism or aortic dissection, you need to have a conversation with your doctor,” Ain said.
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