You knew something was terribly wrong. The pain came out of nowhere.
It was sudden and severe, maybe the worst you ever felt. Many people describe it as a tearing or ripping feeling. It may have been in your chest, or it may have struck between your shoulder blades in your upper back. Maybe it moved as time passed, down toward your belly or into your back. Maybe you felt faint, sweaty, short of breath, or like something catastrophic was happening inside you.
Contact Us for a Free, Confidential Consultation
Article written by Brendan Lupetin, Esq. Brendan is a managing partner in the law firm of Lupetin & Unatin, a medical malpractice law firm located in Pittsburgh and serving Western Pennsylvania.
Our practice is limited to high-value catastrophic cases because that is where we can do the most for our clients and for patient safety.
So you got help fast. You went to the ER. You told them about the terrible pain. And maybe they thought it was something else. Maybe they said it was a heart attack, or acid reflux, or anxiety, or a pulled muscle. Maybe they ran an EKG, said your heart looked okay, and started treating the wrong problem. Maybe they sent you home. The whole time, the tear in your aorta was spreading.
By the time someone ordered the right scan, precious time was gone. Aortic dissection kills quickly when it is missed. Maybe you survived but suffered a stroke, organ damage, or paralysis. Maybe you are reading this because someone you love did not survive at all. And you cannot stop asking: why didn’t they catch this in time?
That question matters. An aortic dissection is one of the most time-sensitive emergencies in all of medicine. When it is missed or treated too slowly, the harm is often catastrophic, and it is often preventable. This article explains the warning signs that an aortic dissection was not diagnosed and treated in time. It explains the serious harm a delay can cause. And it explains what you can do next. If any of this sounds like your story, Lupetin & Unatin is here to help.
What an Aortic Dissection Is, in Plain Terms
The aorta is the largest blood vessel in your body. It carries blood from your heart out to everything else. Its wall has three layers. An aortic dissection happens when the inner layer tears. Blood then surges into the tear and forces the layers apart.
As the Cleveland Clinic explains, this is a life-threatening condition, and the most common sign is sudden, severe, sharp pain in the chest or upper back that can feel like tearing or ripping. Once the tear starts, blood can be pushed away from vital organs. The aorta can also burst. Both can kill within minutes to hours.
Doctors sort dissections into two main types. A Type A dissection involves the part of the aorta closest to the heart. It is a surgical emergency that usually needs immediate open-heart surgery. A Type B dissection involves the part farther down. It is often managed with strict blood pressure control, and sometimes surgery. Either way, the key word is time. Survival drops with every hour that treatment is delayed.
Risk Factors Doctors Are Supposed to Consider
Some people carry a much higher risk of aortic dissection than others. These risk factors matter for two reasons. They make a dissection more likely. And they are supposed to raise a careful doctor’s suspicion when a patient shows up with chest or back pain. A doctor who knows the patient’s history should connect the dots faster.
According to the Mayo Clinic, common risk factors for aortic dissection include:
- High blood pressure. Uncontrolled high blood pressure is the most common risk factor. It puts constant stress on the aortic wall.
- A bicuspid aortic valve. Most people are born with a three-flap aortic valve. Some are born with only two flaps. This is called a bicuspid aortic valve, and it raises the risk of a weakened, enlarged aorta and dissection.
- An aortic aneurysm. A bulge or weak spot already in the aorta makes a tear more likely. Many patients with a known aneurysm are watched for exactly this reason.
- Marfan syndrome and related connective tissue disorders. Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome, and Turner syndrome all weaken the body’s connective tissue, including the wall of the aorta.
- A family history of dissection or aneurysm. Aortic disease can run in families. A known family history should put a doctor on alert.
- Hardening of the arteries (atherosclerosis). This weakens and stiffens blood vessel walls over time.
- Older age and being male. Dissection is more common in men and in people over about 60, though it can strike younger people, especially those with the conditions above.
- Heavy weightlifting or stimulant drug use. Cocaine and intense straining can spike blood pressure and stress the aorta.
- Pregnancy and recent heart surgery or procedures. Both can raise the risk in certain patients.
- Chest trauma. A hard blow to the chest, such as hitting a steering wheel in a car crash, can tear the aorta.
Here is why this matters for your case. When a patient with one of these risk factors comes in with sudden, severe chest or back pain, a careful doctor should move aortic dissection to the top of the list. A young person with Marfan syndrome and tearing chest pain is not a routine case. Neither is a patient with a known bicuspid valve, a prior aneurysm, or a family history of dissection. When those clues are in the chart and the doctor still chases a more common diagnosis without ruling out a dissection, that can be a failure to meet the standard of care.
Why an Aortic Dissection Gets Missed
An aortic dissection is hard to diagnose, but it is not an excuse to miss it. The trouble is that its signs look like more common problems. The pain can mimic a heart attack. The stroke-like signs can mimic an actual stroke. So doctors sometimes chase the wrong diagnosis while the real one spreads.
This is a known and studied danger. According to a systematic review of the medical literature, more than one in three patients with an aortic dissection are misdiagnosed when they first seek care. Doctors are taught to keep dissection in mind, especially when a patient has sudden, severe, tearing chest or back pain. The standard of care often calls for a CT scan to rule it in or out.
Here are the common reasons an aortic dissection gets missed:
- The pain was treated as a heart attack and the real cause was never checked.
- Stroke-like symptoms were blamed on a stroke alone, with no look at the aorta.
- The classic tearing chest or back pain was not taken seriously.
- A CT scan or other imaging was never ordered or was delayed for hours.
- Blood thinners were given, which can make a dissection far worse.
- The patient was sent home with a wrong diagnosis like reflux or anxiety.
Â
Signs Your Aortic Dissection Was Not Diagnosed in Time
Below are the red flags. If you recognize several of these, it may be worth a closer look at the care that was given.
Sudden, Severe, Tearing Chest or Back Pain Was Brushed Off
This is the hallmark sign. The pain of a dissection comes on suddenly and is often described as tearing or ripping. It may sit in the chest or strike between the shoulder blades. If this kind of pain was reported and no one seriously considered a dissection, that is a major red flag.
You Were Treated for a Heart Attack but It Was Something Else
A dissection can look like a heart attack. But the treatments are very different. If you were treated for a heart attack and given blood thinners, and it turned out to be a dissection, that is serious. Blood thinners can worsen the bleeding from a dissection and cause great harm. This trap is well known in medicine, and we explain it in detail in our article on aortic dissection in patients with chest pain and ischemic EKGs.
Stroke-Like Symptoms With Chest or Back Pain Were Not Connected
When a dissection blocks blood flow to the brain, it can cause stroke-like signs. These include weakness on one side, trouble speaking, or vision loss. If those signs came along with severe chest or back pain, the aorta should have been checked. Treating only the stroke can miss the deadly cause behind it.
No CT Scan or Imaging Was Ordered
A CT scan is often the fastest, clearest way to find a dissection. When the signs point to one, imaging should be ordered right away. If hours passed with no scan, or if no imaging was done at all, that gap could be a failure to meet the standard of care.
Key Clues Were on the Chart but Ignored
Certain clues raise the alarm. A big difference in blood pressure between the two arms is one. A new heart murmur is another. A widened aorta on a chest X-ray is a third. High-risk history, like Marfan syndrome or uncontrolled high blood pressure, is another. If these clues were present and no one acted, the diagnosis may have been missed.
You Were Sent Home With the Wrong Diagnosis
Some patients are sent home with a label like acid reflux, a panic attack, or a muscle strain. Then they collapse or return far worse. If you were discharged and the true diagnosis was a dissection, the question is whether a careful doctor would have caught it before letting you leave.
There Was a Long Delay Before Surgery or Treatment
Once a Type A dissection is found, surgery should happen fast. Once a Type B dissection is found, blood pressure must be controlled at once. If the diagnosis was made but treatment was slow to follow, that delay can cause real and lasting harm.
The Serious Harm an Aortic Dissection Delay Can Cause
When a dissection is not found and treated fast, blood is cut off from vital organs and the aorta can rupture. The longer the delay, the more harm it does. Here are the serious injuries and outcomes a missed or delayed diagnosis can cause.
Death. This is the gravest risk. A Type A dissection that is not treated kills a large share of patients within hours to days. Studies show the risk of death climbs with each passing hour. Many patients die before the right diagnosis is ever made. If you lost a loved one this way, your family may have a wrongful death claim.
Stroke. When the tear cuts off blood to the brain, it can cause a stroke. This can leave a person with paralysis, speech loss, vision loss, and lasting disability.
Aortic rupture and massive bleeding. If the weakened aorta bursts, there is sudden, massive internal bleeding. This is often fatal within minutes.
Heart damage. A dissection near the heart can damage the aortic valve or cut off blood to the heart muscle. This can cause heart failure or a heart attack.
Organ failure. The aorta feeds the kidneys, intestines, and other organs. When blood flow is cut off, those organs can be injured or die. This can lead to kidney failure, bowel death, and other grave harm.
Paralysis. When blood flow to the spinal cord is lost, it can cause paralysis of the legs. This can be permanent.
Loss of limb. When the tear blocks blood flow to an arm or leg, the limb can be starved of blood. In severe cases this leads to amputation.
Lasting disability and chronic illness. Survivors often face long recoveries, repeat surgeries, and lifelong monitoring. Many cannot return to the life they had before.
Emotional trauma. Surviving a near-fatal event, or losing a loved one to one, leaves deep wounds. Many people and families struggle with grief, anxiety, and depression for years.
Many of these outcomes share one thing in common. They often trace back to time that was lost. Time that doctors had to act, and did not use.
When a Missed Diagnosis Becomes Malpractice
Not every bad outcome is malpractice. Doctors do not have to be perfect, and aortic dissection is genuinely hard to diagnose. But doctors do have to meet a basic standard. That standard is the level of care a careful doctor would have given in the same situation.
To have a malpractice case, a few things usually need to be true. First, there was a doctor-patient relationship. Second, the care fell below the accepted standard. Third, that failure caused real harm. Fourth, the harm led to losses, such as medical bills, lost income, the loss of a loved one, or pain and suffering.
Aortic dissection cases often turn on a few key questions. Were the classic warning signs present? Did the doctor consider a dissection at all? Was the right imaging ordered in time? Was the patient given a treatment, like blood thinners, that made things worse? When the signs were there and no one acted, that delay can be the heart of a strong case. Proving it takes work, records, and the right medical experts. That is where Lupetin & Unatin comes in.
What You Should Do Now
If you think your aortic dissection, or that of a loved one, was not diagnosed and treated in time, take these steps.
Get the medical records. You have a right to them. They hold the timeline of what happened and when. In these cases, the timing is often the whole case.
Write down what you remember. Note when the pain started and how it felt. Note what you told the doctors and nurses. Note what tests were and were not done, and how long everything took. Memory fades, so do this soon.
Do not wait too long to ask questions. Every state has a deadline for filing a malpractice claim. In Pennsylvania, that deadline is usually two years. There are some exceptions, but the clock can run out fast. Acting early protects your rights.
Talk to a lawyer who knows these cases. Aortic dissection claims are complex. They need medical experts and a deep understanding of emergency, cardiac, and surgical care. A general lawyer may not be the right fit. A firm focused on medical malpractice will know what to look for.
How Lupetin & Unatin Can Help
We are Lupetin & Unatin. We are a Pittsburgh medical malpractice firm. We focus on serious injury and death from medical errors. Cases involving missed and delayed diagnosis of deadly conditions are at the heart of our work. We know how these errors happen. We know how hospitals defend them. And we know how to hold them accountable.
We have handled catastrophic delayed-diagnosis and wrongful death cases, including aortic dissection. You can read one example in our aortic dissection case study. We understand how a treatable emergency can turn fatal when the warning signs are missed and the clock runs out. We know the medicine, and we know how to prove what a careful doctor should have done.
We take a small number of cases so we can give each one real attention. We work on contingency. That means you pay nothing up front. You pay nothing unless we win. There is no risk in finding out if you have a case.
You deserve answers. You deserve to know if this suffering or loss could have been prevented. A short conversation can tell you a lot.
Frequently Asked Questions
You may not know for sure on your own. That is normal. The answer is usually in the medical records. We look at what symptoms were reported, what the doctors wrote down, what tests were ordered, and how long everything took. Aortic dissection is hard to diagnose, but the law asks what a careful doctor would have done with the same information. A careful review tells us whether the care fell below the standard. That review costs you nothing.
In most cases, the deadline in Pennsylvania is two years. For a wrongful death claim, that period generally runs from the date of death. Some exceptions can change the deadline. These rules are tricky, especially in cases involving a death. The safest move is to call us soon so we can protect your rights before time runs out.
Nothing up front. We work on contingency. That means we only get paid if we win money for you. There is no fee to talk with us and no fee to review your case. If we take your case and do not win, you owe us no attorney fee. This lets you seek justice without financial risk.
Reach Out Today
If any part of this article sounds like your story, please contact Lupetin & Unatin. Tell us what happened. We will listen. We will review the records. We will tell you honestly whether we think there is a case.
An aortic dissection can take a life in a matter of hours. A missed diagnosis can change everything. If a hospital or doctor failed you or someone you love, you have the right to seek justice. Let us help you find out what really happened.
Call Lupetin & Unatin today for a free, no-pressure review of your case.