Which pain location is most typical of ascending aortic dissection?

Which pain location is most typical of ascending aortic dissection?

• A. Chest pain radiating to jaw
• B. Anterior chest pain
• C. Abdominal pain
• D. Back pain only

Answer: (B)

Pain location in ascending aortic dissection reflects the part of the aorta that’s involved. The ascending aorta sits in the anterior chest behind the sternum, so when dissection starts there, the patient tends to feel sudden, severe chest pain in the anterior chest region. This is the most common presentation for a dissection of the ascending (Type A) portion. The pain can occasionally radiate to the neck, jaw, or back, but anterior chest pain is the typical hallmark. Back or interscapular pain is more associated with dissections that involve the descending thoracic aorta. Abdominal pain suggests involvement of the abdominal aorta. Chest pain radiating to the jaw overlaps with myocardial infarction more than with ascending dissection.

Pain location in ascending aortic dissection reflects the part of the aorta that’s involved. The ascending aorta sits in the anterior chest behind the sternum, so when dissection starts there, the patient tends to feel sudden, severe chest pain in the anterior chest region. This is the most common presentation for a dissection of the ascending (Type A) portion. The pain can occasionally radiate to the neck, jaw, or back, but anterior chest pain is the typical hallmark.

Back or interscapular pain is more associated with dissections that involve the descending thoracic aorta. Abdominal pain suggests involvement of the abdominal aorta. Chest pain radiating to the jaw overlaps with myocardial infarction more than with ascending dissection.