What to know about aortic dissection, the fatal but treatable heart condition that led to Sen. Lindsey Graham's death

Aortic dissection is an often fatal but treatable heart condition, and a surgeon with Jefferson Health hopes more people can act if they know what to look out for.

The sudden death Saturday of Sen. Lindsey Graham has aortic dissection, the condition that is believed to have killed him, in the news. Here’s what you should know.

What is an aortic dissection?

The aorta is the largest artery in the body. Dr. Joseph Bavaria, a cardiothoracic surgeon with Lehigh Valley Health Network parent Jefferson Health, said the aorta is sort of like the radial tires on modern cars, in that there are three layers. An aortic dissection occurs when a defect in the seam of the inner layer of the aorta causes blood to flow between the middle and inner layers, separating them. The damaged artery can further rupture, causing blood to leak outside the heart, often leading to death.

There are two types of dissection: Type A, where the tear occurs in the part of the aorta that exits the heart, and type B, where the tear occurs in the lower part of the aorta. Bavaria said that type A aortic dissections are more common and much deadlier.

However, all aortic dissections can be fatal. Besides Graham, notable examples of people who died from them include actors John Ritter, Lucille Ball and Alan Thicke, as well as sports journalist Grant Wahl, who died during the 2022 World Cup.

Bavaria estimated that in 20% to 30% of cases, aortic dissection is immediately fatal. For those who survive the initial event, the mortality rate increases by 1% every hour it goes untreated. About 48% of people who experience an aortic dissection die before they reach the hospital.

What are the risk factors?

Bavaria said aortic dissections are likely more common than we realize because of how many people die before they reach the hospital. He added that in the past, aortic dissections were frequently misdiagnosed, due to physicians not even considering it as a possibility. But that is changing in part thanks to an awareness campaign called Think Aorta, which seeks to increase physician and public awareness of the condition.

But at the same time, aortic dissections generally do not occur out of nowhere. Bavaria said hypertension and family history are the two top risk factors.

"This is pretty simple - it’s a pipe under pressure, that’s what our aortas are," Bavaria said. "So keeping a decent blood pressure is really important. The second thing on that front is to know your family history. Because that's actually maybe the most important thing. If you have a family history of dissection, that’s the worst sign."

Other risk factors include buildup of substances in and on the artery walls, an aortic aneurysm, having a bicuspid aortic valve, an aortic coarctation or having certain syndromes.

What are the symptoms?

There are symptoms when the aorta dissects that help indicate something was wrong. These include upper back pain, sudden severe stomach pain, loss of consciousness, shortness of breath, leg pain, trouble walking or stroke-like symptoms such as sudden vision problems, trouble speaking and weakness or loss of movement on one side of the body.

Bavaria said one of the top indicators that you may be experiencing aortic dissection is chest pain, and that is not something to walk off. Graham apparently had been experiencing chest pain for hours before he died.

"If you got chest pain, man, don’t blow it off. Go to the emergency room and see somebody," Bavaria said.

The good news that if a patient heeds signs that something is wrong and they make it to the hospital, there is a roughly 80% chance they will survive. At the hospital, treatment almost always involves surgery, unless the patient is over the age of 85. Bavaria said that he has advocated for sending patients directly to the operating room, similarly to the way trauma patients are handled. Compared to just a few decades ago, chances of surviving this highly deadly condition are much higher.

"We used to be at the 30/30 club, which was that when a patient came in in the 1990s, there was a 30% mortality rate, 30% stroke rate,” he said. “We’re down to about a 5% stroke rate and about a 12% mortality rate now. So bottom line is if you get through the operating room doors, you have about an 80% chance of doing reasonably well."

Copyright 2026 Tribune Content Agency. All Rights Reserved.