It is a serious disease caused by a rupture of the inner layer of the aorta artery in its most proximal portion. The aorta is the largest blood vessel in the body.
The exact cause is unknown but risk factors such as the accumulation of fatty plaques in the artery, arterial hypertension, smoking, aortic aneurysm, chest trauma, hereditary diseases, previous cardiac surgery, pregnancy and vasculitis have been described.
It manifests with very intense chest pain (often described as tearing) that may radiate to the back and shoulder blades. It may also present pain in other areas of the body such as the neck, arm, jaws, abdomen and/or hips. Other accompanying symptoms: anxiety, the sensation of death, dizziness, fainting, nausea and vomiting, cold and sweaty skin, weak and rapid pulses, asymmetric pulses, choking, abdominal pain and difficulty swallowing.
Diagnosis is made by directed history taking and a complete physical examination. Palpation and assessment of pulses on both sides of the body is important to study asymmetries. Confirmatory diagnosis will be obtained by computed tomography.
The definitive treatment is urgent surgery. The associated pain and hypertension should be controlled with analgesics and antihypertensive drugs.
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