Sen I, D’Oria M, Weiss S, et al. - Via performing a population based study, researchers investigated the incidence, natural history and treatment outcomes of isolated abdominal dissection (IAD) to better characterize this disease. Using the Rochester Epidemiology Project, they identified 133 residents with aortic syndrome (aortic dissection, intramural hematoma, or penetrating ulcer); of these, 23 were initially diagnosed with IAD. Reclassification of nine as penetrating aortic ulcer (PAU) led to their exclusion, leaving 14 patients for review (10 male (71%), mean age 71 years). Observations here suggest rare occurrence of isolated abdominal dissection. Asymptomatic patients had medical management initially. Slow aortic growth rate, with no aortic related mortality and a low rate of aortic intervention was observed. Overall there was similar mortality to population controls. Given the prevalence of heart failure and cardiac related death, this patient population requires close cardiovascular care.