Lindsey Graham died from rare aortic dissection, officials say

The District of Columbia Office of the Chief Medical Examiner said Sen. Lindsey Graham died of an aortic dissection, a tear in the body’s main artery that can become lethal before doctors have time to identify it. Graham was 71. His office said the death certificate would remain pending until toxicology and microscopic testing were complete.

Graham was pronounced dead at 10:23 p.m. Saturday at George Washington University Hospital after being transported there in Washington, D.C. A recording tied to the emergency response referenced cardiac arrest, and Sen. Tommy Tuberville said Graham had called a scheduler complaining of chest pains and asked her to call 911. Graham’s office also said he had recently returned to the United States after travel.

Aortic dissection is a medical emergency in which a tear forms in the inner wall of the aorta. Because it can resemble a heart attack or pulmonary embolism, rapid diagnosis is critical. Warning signs can include sudden severe chest pain or upper back pain that spreads to the neck or back. The American Heart Association puts the estimated incidence at 5 to 30 people per million.

Hypertension is likely the most direct and probable cause in many cases, while smoking is another common modifiable risk factor. Adults 65 and older with atherosclerotic heart disease and uncontrolled high blood pressure face significantly increased risk. The National Heart, Lung, and Blood Institute puts annual U.S. deaths at about 13,000.

Current aortic-disease guidance divides dissections into Type A and Type B. Type A involves the ascending aorta near the heart and is generally the more severe form. The 2022 ACC/AHA aortic disease guideline also recommends family screening, including genetic testing and imaging, for first-degree relatives in certain cases involving aortic root or ascending thoracic aneurysms or aortic dissection.