How a Torn Aorta Can Do Lethal Damage

By DENISE GRADY
NYT

The death of the veteran diplomat Richard C. Holbrooke last week shocked Americans and his many colleagues around the world. Mr. Holbrooke, 69, was a larger-than-life figure, a fearless and robust man who was apparently struck down without warning.

He became ill on a Friday, and was dead by Monday. According to government officials, the cause was a tear in his aorta, the artery that carries blood from the heart to vessels that feed the rest of the body.

Mr. Holbrooke underwent 21 hours of surgery from Friday to Saturday to repair the damage, and then another seven-hour operation on Sunday, all at George Washington University Medical Center in Washington. But no amount of surgery could save him.

Aortic tears may be unfamiliar to most people, but they kill at least 2,000 Americans a year, and possibly more, because some of the deaths may be mistakenly attributed to heart attacks. Tears are more common in men than in women, and most likely in people from 40 to 70. Their causes include uncontrolled high blood pressure, atherosclerosis and a genetic tendency to have weak tissue or an abnormal valve in the aorta. There may be no warning signs before the tear occurs.

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