Which is the most common cause of death in a patient with an aortic dissection?

• A. Heart Failure
• B. Stroke
• C. Renal Failure
• D. Rupture into Cavities

Answer: (D)

The main idea is that death from an aortic dissection most often results from rupture into the pericardial space, causing cardiac tamponade. When the tear extends outward and blood spills into the pericardial cavity, a hemopericardium rapidly compresses the heart. This prevents the chambers from filling properly, drops cardiac output, and leads to swift, fatal circulatory collapse. While malperfusion can cause strokes or renal failure and rupture into other spaces can occur, those are less likely to be the immediate cause of death compared with tamponade. So rupture into the pericardial cavity causing tamponade is the most common fatal event in aortic dissection.