Which layer of the aortic wall develops a tear that can lead to blood leakage and formation of a false lumen?

The intimal layer of the aortic wall is the innermost layer, and a tear in this layer is typically where conditions such as aortic dissection begin. When this layer is compromised, it can lead to blood penetrating the wall of the aorta, resulting in the formation of a false lumen. This separation can allow blood to flow between the layers of the aortic wall, creating this false lumen, which can have significant clinical consequences.

The intimal layer is vital in maintaining the structural integrity of the aorta, and damage here can lead to life-threatening situations. In aortic dissections, this initial tear in the intima often allows the blood to track into the media layer, accommodating the shear stress and further complicating the situation.

The media layer provides the structural support and elastic properties necessary for normal aortic function, while the adventitia layer serves as the outer protective covering. The pericardial layer is not part of the aortic wall but rather surrounds the heart. Thus, while other layers have important roles, the intimal layer is specifically crucial for the initiation of a process that causes the formation of a false lumen in aortic dissections.