The sudden death of Sen. Lindsey Graham (R-S.C.) on Saturday at age 71 has been attributed to an aortic dissection, a rare but often lethal condition, according to D.C. Chief Medical Examiner Francisco Diaz. In a statement Sunday, Diaz said preliminary findings indicate the cause was “aortic dissection due to arteriosclerosis cardiovascular disease.” The official cause remains pending pending further testing, including toxicology and microscopy.
Aortic dissection occurs when the wall of the aorta—the body's largest artery—tears, allowing blood to create a flap that can extend into the aorta and trigger a heart attack. The condition is difficult to predict. “It's really a heart surgery, a thoracic surgery, where the surgeons go in and try to stabilize the aorta,” said Manesh Patel, volunteer president of the American Heart Association and chief of cardiology at Duke University. “Sometimes they can put a stent in. Sometimes they have to actually operate. Most of the time, they have to operate to stabilize the aorta and or suture or replace portions of the aorta.”
Emergency medical services responded to a call from Graham's Capitol Hill home for “cardiac arrest,” according to scanner audio obtained by NBC News. Graham, who had heart disease, met several risk factors for aortic dissection, which are less common in women, younger individuals, and those without a family history of atherosclerosis or hypertension. His father, F.J. Graham, died of a heart attack at 69, just two years younger than the senator.
Other risk factors include high blood pressure, tobacco use, and a family history of aortic aneurysms or dissections. Aortic dissections are relatively rare, with an estimated incidence of 5 to 30 per million people, but Patel noted the rate could be higher as understanding evolves. Mortality rates range from 30 to 50 percent.
There are two types: those in the ascending aorta, closer to the heart, and those in the descending aorta. Ascending dissections require emergency surgery, with every hour of delay increasing the risk of death, Patel said. Descending dissections are “less unstable” and can be managed medically. The AHA's 2022 guidelines stress rapid recognition and treatment.
Graham's death has already sent shockwaves through the Senate, triggering a fierce succession battle. South Carolina Governor Henry McMaster appointed Graham's sister to fill the seat temporarily, while former President Donald Trump has backed Darline Graham Nordone for the permanent role. The FBI has also joined the investigation, though no foul play is suspected.
The sudden loss of a senior Republican senator has upended legislative priorities, including a push by Trump for a crypto bill and broader policy debates. As the medical examiner completes its work, the political fallout continues to reshape the Senate landscape.
