• chest pain
  • sudden, severe, sharp, stabbing, tearing, or ripping
  • located below the sternum, then radiates under the shoulder blades or to the back
  • may radiate to shoulder, neck, arm, jaw, abdomen, or hips
  • location may change -- pain typically moves distally (to arms and legs) as the aortic dissection progresses in the same direction
• changes in thought ability, confusion, disorientation
• decreased movement, any location
• decreased sensation, any location
• intense anxiety, anguish
• pallor
• rapid pulse
• profuse sweating
• dry skin/mouth, thirst
• nausea and vomiting
• dizziness, fainting
• shortness of breath -- difficulty breathing when lying flat (orthopnea)

The symptoms usually begin suddenly.

Additional symptoms that may be associated with this disease:

• excessive yawning
• clammy skin
• weak or absent pulse
• cough
• high blood pressure

Listening with a stethoscope at the chest and abdomen may reveal a "blowing" murmur over the aorta, a heart murmur, or other abnormality. There may be decreased (weak) pulses in the arms and hands.

There may be low blood pressure, bulging neck veins, or signs resembling a heart attack. There may be signs of shock (inadequate blood flow to the body tissues), but with normal blood pressure.

Aortic dissection or aortic aneurysm may be revealed on:

• Echocardiogram -- ultrasound examination of the heart
• Transesophageal echocardiogram (TEE)
• Chest x-ray -- may show mediastinal (chest) widening or pleural effusion (fluid in the lining of the lung)
• Chest MRI or CT scan of chest with dye
• Aortic angiography
• Doppler ultrasonography (occasionally performed)