Ask Kelly question about back pain and aortic dissection

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Ask Kelly question:

Hi, 14 years ago I had a spontaneous dissection of the LAD descending. August  23rd of this year I had horrible building pain in my upper back. Shortness of breath, nausea and sweating. I thought it was just my back. Before I got upstairs to lie down my chest started hurting. So, I took an aspirin, because that happens often. However, in several minutes ALL pain was gone. I was shocked because the back pain had me in tears, I had taken a T3 two hours earlier to no effect. I have pain in my back daily now and an aspirin usually takes care of it.

My cardiologist wants me to get a CT scan, but I am not insurable because of my first attack. I am, female and 55 years old. It seems my symptoms indicate a dissection of the aorta, is this possible?

What exactly does it mean?

My doctor was too busy berating me for not quitting smoking and not having insurance to explain. Also, I am under stress because my husband has a few mental illnesses with BIG control issues. Thank you.

Response by Dr. Christopher Wolfram, Cardiology Associates of Green Bay

It would be extremely unusual for severe back pain caused by an aortic dissection to spontaneously resolve.  It is more likely that the cause of that episode of pain and possible your recurrent pain is musculoskeletal.  That being said, I do not blame your cardiologist for wanting to get a CT scan to evaluate your aorta.  Certain medical conditions that can predispose people to having a coronary artery dissection, can also predispose people to having aneurysm or dissection of your aorta, which can be life threatening.

You, like many others in our society are unfortunate to not have heath insurance coverage.  This is a major problem that in many cases results in people avoiding preventative care and presenting for care only at the time of emergency, sometimes only after the damage is done.  An office visit with a different cardiologist or other physician may be a less expensive way to have some improved insight into your condition and help you to decide what expense you are willing to incur depending on how serious the problem may be.

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