An aortic dissection occurs when a tear develops in the inside layer of the aorta, which is the largest artery in the body and carries blood away from the heart to the rest of the body. An aortic dissection is relatively rare, but more common in those with high blood pressure, or hypertension, combined with a weak spot in the aorta or aortic dilation. An aortic dissection can occur during episodes of intense physical exertion, like weightlifting, because of hypertension 1.

Significance

In an aortic dissection, blood flows through the middle layer of the aorta, causing the inside and middle layers to dissect, or separate. According to MayoClinic.com, if this channel of blood ruptures through the outer aortic wall, dissection is usually fatal. Unfortunately, a dissection can kill many young athletes, because:

• serious health consequences like massive internal bleeding
  
• organ damage to kidneys or intestines
  
• stroke
  
• bleeding into the lining surrounding the heart
  
• damage to the aorta itself

Types

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There are two types of aortic dissection, type A and B 3. Type A aortic dissection is the most serious and occurs when there is a tear in the ascending part of the aorta where it leaves the heart and may involve a tear from the ascending part down to the descending aorta, extending into the abdominal cavity. Type A dissections usually require surgery so the dissected portions can be removed and replaced with a man-made tube. Sometimes the entire aortic valve needs to be replaced if there is extensive damage. Type B aortic dissection is a tear in the descending aorta and may extend into the abdominal cavity. This type of tear is treated medically or surgically, depending on the requirements of the dissection.

Weightlifting

An article published in the "Cases Journal" follows the case of aortic dissection in a 37-year-old hypertensive man experiencing aortic dissection while lifting weights 1. The article indicates that aortic dissection can occur in weightlifters, throwers and wrestlers at the time of physical exertion, particularly if there is a history of hypertension. According to a study conducted by Dr. John Elefteriades at Yale New Haven Hospital, blood pressure can rise dramatically during heavy weightlifting, presenting the risk of aortic dissection because of the extra stress placed on the artery. The number of cases of heavy weight lifting resulting in aortic dissection is small, but those who have a history of aortic dilation and hypertension should be careful. If you have a known cardiac illness or are over 40, see a doctor before beginning a physical exertion exercise like weightlifting.

Prevention

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This information doesn't mean you can no longer lift weights or perform activities requiring intense physical exertion, as resistance training is an important part of an overall fitness program and poses no risk to the majority of the population. An article published in "The Journal of Cardiovascular Surgery" indicates that individuals participating in heavy exertion exercises will benefit from cardiac screening performed before the activity so that unknown aortic weaknesses and dilations are identified. In addition, those who have a known aortic dilation should only lift 50 percent of body weight because of the danger of extreme hypertension in these individuals.