A spontaneous tear of the ascending aorta, with or without medial dissection, can cause
sudden death from hemorrhage due to aortic rupture. Two representative cases are
described. Review of the clinical history and pathological changes showed that the terminal
event was delayed allowing healing and reactive changes to occur in the aortic wall. A
pathologist confronted with a fatal case of aortic rupture should be aware that death is not
always immediate. Recognition of this has medicolegal importance, particularly if medical …