When I heard that US diplomat Richard Holbrooke died suddenly last week I first thought, "What a shame that a man who did so much for global affairs had his life snuffed out at just 69!" But only a split second later a different, self-centered thought came galloping into my brain: "What did he die of, and could it happen to me???" As a health writer and a chronic worrier I feel compelled to Google to death every disease or condition I ever hear of, but I'd never read about the thing that killed Holbrooke: an aortic tear.
So, in case you were also wondering, here's the scoop on this condition, which is more properly called "aortic dissection": It happens when the inner lining of the aorta (the main artery out of the heart) tears, leading blood to seep into the area between the inner and middle linings of the artery, sometimes rupturing the artery and letting blood flow into the chest cavity. The main risk factors for aortic dissection are high blood pressure, atherosclerosis and other vascular conditions, though it can also be caused by a blow to the chest such as might occur in a car accident. The symptoms, which mimic a heart attack, are sudden intense pain in the chest and/or upper back, shortness of breath and fainting (here is a complete list on the Mayo Clinic site). Scarily, aortic dissection is somewhat hard to diagnose, and usually life-threatening and requiring immediate treatment. Holbrooke was apparently in Hillary Clinton's office on Friday when he collapsed, was rushed to the hospital and into 20 hours of surgery. He died on Monday evening.
Although relatively rare, aortic dissection is most common in men in their 60s and 70s, so it's especially important for them (and the people who love them) to understand the risk. To help prevent this and other dangerous cardiovascular events such as aneurysms, the Society for Vascular Surgery recommends that all men 65 or older have an ultrasound to screen for potential problems, and men with a family history of aortic aneurysms should be screened at 55. Women should be screened at 65 if they have a family history or have smoked. For more on vascular screening, read this statement on the subject.