Wir überwinden Grenzen

(17.09.2025) A rupture of the aorta is a medical emergency that is often mistaken for a heart attack. A recent case at the Medical Center - University of Freiburg shows how crucial rapid action can be.

At the end of August, a 64-year-old man was admitted to hospital with acute chest pain. Initially, a heart attack was suspected - but all tests were negative. He was discharged home. The next day, the pain returned. This time, the possibility of an (imminent) rupture of the main artery, known as the aorta, was considered. An immediate transfer to the Medical Center - University of Freiburg followed. Just a few hours later, the patient was in the operating theater - which probably saved his life.

At the end of August, a 64-year-old man was admitted to hospital with acute chest pain. Initially, a heart attack was suspected - but all tests came back negative. He was discharged home. The next day, the pain returned. This time, the possibility of an (imminent) rupture of the main artery, known as the aorta, was considered. An immediate transfer to the Medical Center - University of Freiburg followed. Just a few hours later, the patient was in the operating theater - which probably saved his life.

Acute aortic dissection is a life-threatening emergency

"With symptoms like these, you can't just think of a heart attack. Aortic dissection is much rarer than a heart attack, but it is extremely dangerous and a life-threatening emergency," emphasizes Prof. Dr. Martin Czerny, Medical Director of the Department of Cardiovascular Surgery at the Medical Center - University of Freiburg in Bad Krozingen. The patient was admitted on August 28 and operated on immediately. After a complex operation using the so-called elephant trunk technique, his aorta was completely stabilized. Almost three weeks later, he was discharged home in very good condition.

What is an aortic dissection?

In an aortic dissection, the inner wall layer of the aorta tears. Blood flows into the vessel wall, separating its layers and can interrupt the supply to vital organs. The disease is rare, but highly dramatic: according to the German Heart Foundation, up to 50 percent of those affected die within 48 hours without prompt treatment. Typical symptoms are the sudden onset of severe pain in the chest or back area, which is often described as "tearing" - the so-called "annihilation pain".

"Vigilance can save lives"

The disease occurs more frequently in people over 60, especially if they have pre-existing conditions such as high blood pressure or genetic risks - for example, due to connective tissue disorders such as Marfan syndrome or Loys-Dietz syndrome, as well as in people with a congenital defect in the aortic valve. A tear in the section of the aorta close to the heart requires immediate emergency surgery. The majority of patients with a dissection in other segments of the aorta are treated minimally invasively or with medication.

Raising awareness on the day of action on September 19

"It is crucial that we raise awareness of aortic dissection. It is too often overlooked," says Czerny. The "Aortic Dissection Awareness Day" on September 19 is intended to draw attention to precisely this: Such an event is not a rare individual fate, but an often unrecognized danger.

Don't look away at warning signs

The case of the 64-year-old man shows how close it can sometimes be - and how important a clear diagnosis is. Anyone who suddenly experiences severe chest or back pain should not hesitate to seek medical help. Because: an aortic dissection knows no time. "Every minute counts," says Czerny. And emphasizes: "Chest pain is not always a heart attack. Even rare causes such as aortic dissection can be life-threatening.

Checklist: Recognize aortic dissection

Typical warning signals

• Sudden onset of very severe pain
• Often described as "tearing"
• Pain pulls in the chest, back or abdomen

Risk factors

• Age over 60 years
• High blood pressure
• Connective tissue disorder such as Marfan syndrome
• Congenital defect in the aortic valve

What to do in an emergency?

• Call 112 immediately
• Describe symptoms clearly ("sudden, extreme, tearing")
• Do not wait - every minute counts!

More interesting articles