Evidence shows Sen. Lindsey Graham (R-S.C.) died of an aortic dissection, which medical officials say is a rare and life-threatening condition that requires immediate emergency treatment.
Graham’s death at age 71 was announced by his family on Saturday night. On Sunday, the Medical Examiner of the District of Columbia reported that preliminary findings show his cause of death was from an aortic dissection due to arteriosclerotic cardiovascular disease. That means an aorta rupture that stemmed from the hardening of Graham’s arteries.
Graham’s office said on Saturday that the senator passed away after a “brief and sudden illness.”
“Senator Graham’s family appreciates prayers at this time and asks for privacy during this incredibly difficult period,” the office said in a statement posted to social media.
“The death certificate will be PENDING until all the toxicological and microscopic testing is finalized and at that point the death certificate will be updated to reflect the cause of death and appropriately classify the manner of death,” the office of Dr. Francisco Diaz, the chief medical examiner for the District of Columbia, said in a statement to media outlets on Sunday.
What Causes an Aortic Dissection?
The aorta is the largest artery in the human body, which arches up from the heart and curves through the abdomen. The artery is responsible for carrying oxygen-rich blood to the rest of the body through other arteries that are connected to it, according to medical officials.
“A tear in the wall of the aorta allows blood to pass through the tear and creates a flap that extends in the aorta and can lead to complications including heart attack, bleeding, or rupture through the back of the wall,” said the American Heart Association in a statement on Monday.
The tear, or dissection, reduces the blood flow to vital organs, while it can sometimes can lead to a rupture that sends blood into surrounding tissues in the body, health experts say.
A tear can create two channels, including one where the blood remains still and another where blood continues to travel, according to the MedlinePlus government website. Should the channel with the still blood get larger, it can press on other parts of the aorta, potentially narrowing other branches and reducing their blood flow.
The condition can also trigger an aneurysm in the aorta, or a balloon-like bulge in the artery, health officials said. According to the Centers for Disease Control and Prevention (CDC), aortic aneurysms can dissect or rupture.
“The force of blood pumping can split the layers of the artery wall, allowing blood to leak in between them. This process is called a dissection,” the CDC says in an article published on its website. But if the aneurysm bursts entirely, that’s called an aortic rupture, it said.
A rupture is considered the “most serious complication of a thoracic aneurysm,” said a study published in the National Library of Medicine, while a separate study described it as a “catastrophic event.” The D.C. medical examiner said only that he died from an aortic dissection, not a rupture.
Aortic dissections can also trigger other complications such as strokes, organ damage, and poor blood flow, the Mayo Clinic says on its website.
Medical Emergency
The American Heart Association said Monday that an aortic dissection is considered a medical emergency that can rapidly become fatal if not quickly diagnosed and treated.
According to the Cleveland Clinic’s website, the condition “can cause sudden death” without treatment. It advised those who suspect having any symptoms to quickly seek emergency treatment.
Treatment generally requires surgery, which may include a surgeon removing a portion of the damaged section of the aorta and sewing a synthetic tube in its place, the clinic says on its website. Other procedures may be required to repair other parts of the aorta or blood vessels. A surgeon may also repair the aorta by using a stent graft that reinforces the weak area of the aorta.
Health officials with the Mayo Clinic say there are two types of aortic dissections: Type A and Type B. Type A, which is considered more common, is a tear in the aorta near where it exits the heart, or it can also occur in the upper part of the artery. Type B is a tear that occurs in the lower aorta closer to the stomach.
Despite treatment options, the clinic adds that around 40 percent of people with Type A aortic dissection “die immediately from complete rupture and bleeding out from their aorta.”
Risk Factors
Risk factors include high blood pressure, high cholesterol that in turn stiffens arteries, and smoking, health officials said. It’s more common in older people but also can be caused by certain genetic conditions in younger people.
American Heart Association volunteer president Manesh Patel said in a statement that the condition is also often “more common in men than women, with an estimated incidence of 5 to 30 people per million.” Most people who suffer an aortic dissection are aged 50 to 70, he added.
“People with risk factors including high blood pressure, tobacco use, or family history of aortic aneurysms or dissections, should discuss aortic aneurysm risk and screening with their physicians,” Patel said.
More than 9,900 people died in 2019 from an aortic dissection or aortic aneurysm, the CDC said in an article in 2024. It also said that a history of smoking tobacco accounted for 75 percent of all abdominal aortic aneurysms, which the agency defines as an abdominal aortic aneurysm that occurs below the chest.
Symptoms and Signs
Health officials said that an aortic dissection can mimic other heart conditions such as a heart attack, according to the Mayo Clinic.
Symptoms tend to come on quickly, with severe and sudden pain, often in the chest or back but sometimes in the neck, jaw, or abdomen, depending on where in the aorta the tear happened, according to the American Heart Association.
Other signs include feeling faint, a weakness or shortness of breath, sudden stomach pain, loss of consciousness, stroke-like symptoms such as trouble speaking or vision problems, or leg pain and trouble walking.
The CDC says on its website that “abdominal aortic aneurysms often don’t have any symptoms” but they can include a throbbing or deep pain in the back or side, or pain in the legs, groin, and buttocks.
The Associated Press contributed to this report.
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