Longtime Republican Senator Lindsey Graham died after a “brief and sudden illness” on Jul. 11 at the age of 71. 

According to Graham’s communications director, Taylor Reidy, preliminary findings from the medical examiner of the District of Columbia found that the attorney died from “aortic dissection due to arteriosclerotic cardiovascular disease.” 

Mere hours before Graham’s death, emergency personnel arrived at his Capitol Hill address in response to a report of someone suffering chest pain, which is the most common symptom of an aortic dissection. 

What Is an Aortic Dissection?

An aortic dissection is a tear in the lining of the aorta—the largest blood vessel that runs down the middle of the body and transports blood with oxygen from the heart to the rest of the body.

“Blood then flows into this space, causing the layers of the aorta split apart during a dissection,” Jonathan Gower, MD, a cardiac surgeon at MedStar Washington Hospital Center, told Verywell in an email.

“This can occur anywhere from where the aorta first joins the heart to anywhere along it. The layers of the aorta can separate in either direction, depending on location. This is a true surgical emergency,” Gower added.

An aortic dissection can reduce blood flow to organs or cause the aorta, which is also the main artery in the body, to rupture. 

This condition can be life-threatening, with the highest mortality risk in the first few hours. Almost 40% of people with the heart condition die instantly, with the risk of death increasing by four percent every hour it is not treated.

Related Stories

Could It Be My Heart? Types and Causes of Chest Pain

Bigeminy and Your Heartbeat: When to Worry and Why

What Are the Symptoms? 

The hallmark symptom of an aortic dissection is sudden and severe pain in the chest or upper back, with the feeling often described as “ripping.” If someone’s experiencing extreme chest or upper back pain, they should get medical care right away.

Other symptoms include abdominal or stomach pain, low blood pressure, shortness of breath, difficulty speaking or walking, loss of vision, and a rapid or weak pulse. 

What Are the Causes and Who’s at Risk? 

Although the causes of an aortic dissection can vary, some factors include inflammatory disease, high blood pressure, or a family history of dissections. Aortic dissection can occur in nearly two out of every 10,000 people, and while it can affect anyone, it is most often seen in men between the ages of 40 and 70.

People who have high cholesterol, inflamed arteries, a history of smoking, or have experienced physical trauma that damaged the aorta could be at higher risk for a dissection.

Deposits of fat or calcium, also known as atherosclerosis, and genetic disorders that affect the body’s connective tissue, like Marfan syndrome, can contribute to the development of a dissection.

How Is the Condition Treated? 

There are two main types of aortic dissection, based on the location of the tear. Type A dissection, the most common and severe, is a tear near the heart of the ascending aorta that can extend into the abdomen. A Type B dissection, which can also extend into the abdomen, is a tear in the descending aorta.

The treatment option depends on the location of the dissection.

“A type A dissection starts in the ascending aorta and can involve the entire aorta. This is treated with emergent aortic replacement surgery,” Gower said. “A Type B dissection can be treated medically by lowering heart rate and blood pressure. However, there are times when it still requires surgical treatment, like if it’s showing signs of malperfusion to the organ.” 

Surgical options included an open surgical repair, where an incision is made directly on the damaged aorta, or an endovascular repair, which involves a stent graft being placed inside the aorta through an incision in the groin. 

There are also medications used to lower blood pressure, but that alone is not a treatment for a dissection. However, people can lower their risk of dissection by monitoring their blood pressure and cholesterol levels.