As the false lumen increases in size, arterial flow to the true aortic lumen and to arteries arising from the aorta may be blocked or disrupted. Depending upon the location of the primary intimal tear and the direction of dissection propagation, various vital organs may loose arterial blood supply, and the aorta may rupture into the pericardial sac or pleural space, leading to cardiac tamponade or free pleural rupture. Blood flow from the false lumen may reenter the true lumen through another intimal tear, which may occur proximal or distal to the first, depending on the direction of dissection propagation.