Materiały źródłowe

• #1 Aortic dissection: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000181.htm

  Aortic dissection most often happens because of a tear or damage to the inner wall of the aorta. This very often occurs in the chest (thoracic) part of the artery, but it may also occur in the abdominal aorta. […] The exact cause is unknown, but more common risks include: […] Other risk factors and conditions linked to aortic dissection include: […] Aortic dissection occurs in about 2 out of every 10,000 people. It can affect anyone, but is most often seen in men ages 40 to 70.

• #2 What is aortic dissection: What you need to know about the causes, types and more – UChicago Medicine

  https://www.uchicagomedicine.org/forefront/heart-and-vascular-articles/2022/january/silent-killer-everything-you-need-to-know-about-aortic-dissection

  More than 13,000 people die from an aortic dissection each year in the United States. […] We find that patients with poorly controlled blood pressure are at most risk for aortic dissection. Additionally, those with pre-exciting connective tissue diseases, such as Marfans syndrome, Ehlers-Danlos syndrome and other collagen vascular disorders, are also at high risk for aortic tears. Other common risk factors include an existing aneurysm, polycystic kidney diseases or even chest trauma that can lead to an aortic dissection.

• #3 Acute Aortic Dissection • LITFL • CCC Cardiology

  https://litfl.com/acute-aortic-dissection/

  the most common catastrophe of the aorta (3:100,000); 3 times more common than abdominal aortic aneurysm (AAA) rupture […] aortic dissection is a type of acute aortic syndrome (AAS) characterized by blood entering the medial layer of the wall with the creation of a false lumen. […] There are 3 possibilities as to how the blood enters the media: Atherosclerotic ulcer leading to intimal tear […] Disruption of vasa vasorum causing intramural haematoma […] De novo intimal tear […] Hypertension (72% (and other CV risk factors: smoker, lipids)) […] infection (syphilis) […] arteritis such as Takayasus or giant cell […] aortic dilatation / aneurysm […] wall thinning […] crack cocaine (abrupt catecholamine-induced hypertension) […] Inherited disease (especially younger patients 40 yrs) […] Marfans syndrome (fibrillin gene mutations) […] Ehlers-Danlos syndrome type IV (collagen defects) […] Turner syndrome […] annulo- aortic ectasia […] familial aortic dissection.

• #4 Aortic dissection – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-dissection/symptoms-causes/syc-20369496

  An aortic dissection is caused by a weakened area of the aorta’s wall. […] Aortic dissections are divided into two groups, depending on which part of the aorta is affected: […] Type A. This more common and dangerous type involves a tear in the part of the aorta where it exits the heart. The tear may also occur in the upper aorta (ascending aorta), which may extend into the abdomen. […] Type B. This type involves a tear in the lower aorta only (descending aorta), which may also extend into the abdomen.

• #5 Aortic dissection – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-dissection/symptoms-causes/syc-20369496

  An aortic dissection is caused by a weakened area of the aorta’s wall. […] Aortic dissections are divided into two groups, depending on which part of the aorta is affected: […] Type A. This more common and dangerous type involves a tear in the part of the aorta where it exits the heart. The tear may also occur in the upper aorta (ascending aorta), which may extend into the abdomen. […] Type B. This type involves a tear in the lower aorta only (descending aorta), which may also extend into the abdomen.

• #6 Aortic dissection – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-dissection/symptoms-causes/syc-20369496

  An aortic dissection is caused by a weakened area of the aorta’s wall. […] Aortic dissections are divided into two groups, depending on which part of the aorta is affected: […] Type A. This more common and dangerous type involves a tear in the part of the aorta where it exits the heart. The tear may also occur in the upper aorta (ascending aorta), which may extend into the abdomen. […] Type B. This type involves a tear in the lower aorta only (descending aorta), which may also extend into the abdomen.

• #7 Etiology of aortic dissection – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30689200/

  We discuss the etiology of aortic dissection (AD) from various points of view. The development of AD requires two pathological conditions: medial degeneration and mechanical wall stress. […] The clinical causes of medial degeneration include hypertension, aortic aneurysms, obstructive sleep apnea, and connective tissue disorders. […] Mechanical wall stress is supposedly induced by shear stress caused by blood flow, together with hypertension and aortic root movement. Further investigation is necessary in the search for mechanisms responsible for medial degeneration prior to AD development.

• #8

  https://link.springer.com/article/10.1007/s11748-019-01066-x

  We discuss the etiology of aortic dissection (AD) from various points of view. The development of AD requires two pathological conditions: medial degeneration and mechanical wall stress. First, histopathological findings of medial degeneration are hypothesized to be due to a loss of elastic fibers and interconnecting elastic fibers. Damage to the vasa vasorum plays a key role in creating an entry site. The clinical causes of medial degeneration include hypertension, aortic aneurysms, obstructive sleep apnea, and connective tissue disorders. Second, mechanical wall stress is supposedly induced by shear stress caused by blood flow, together with hypertension and aortic root movement. Further investigation is necessary in the search for mechanisms responsible for medial degeneration prior to AD development. […] The clinical causes of medial degeneration include hypertension, aortic aneurysms, obstructive sleep apnea, and connective tissue disorders. […] Mechanical wall stress is supposedly induced by shear stress caused by blood flow, together with hypertension and aortic root movement.

• #9 Aortic dissection | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/aortic-dissection?lang=us

  Aortic dissection is the prototype and most common form of acute aortic syndromes and a type of arterial dissection. It occurs when blood enters the medial layer of the aortic wall through a tear or penetrating ulcer in the intima and tracks longitudinally along with the media, forming a second blood-filled channel (false lumen) within the vessel wall. […] The majority of aortic dissections are seen in elderly hypertensive patients. In a very small minority, an underlying connective tissue disorder may be present. Other conditions or predisposing factors may also be encountered, in which case they will be reflected in the demographics. Examples include: atherosclerosis, structural aortic abnormalities, inherited connective tissue disorders, Turner syndrome, pregnancy, prior intervention, and ciprofloxacin use.

• #10 Aortic Dissection – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/diseases-of-the-aorta-and-its-branches/aortic-dissection

  Aortic dissections often occur in patients with preexisting degeneration of the aortic media. Causes and risk factors include connective tissue disorders, atherosclerotic disease, systemic rheumatic diseases, and injury. […] Atherosclerotic risk factors, notably hypertension, contribute in more than two-thirds of patients. After rupture of the intima, which is a primary event in some patients and secondary to hemorrhage within the media in others, blood flows into the media, creating a false channel that extends distally or, less commonly, proximally along the artery.

• #11

  https://link.springer.com/article/10.1007/s11748-019-01066-x

  We discuss the etiology of aortic dissection (AD) from various points of view. The development of AD requires two pathological conditions: medial degeneration and mechanical wall stress. First, histopathological findings of medial degeneration are hypothesized to be due to a loss of elastic fibers and interconnecting elastic fibers. Damage to the vasa vasorum plays a key role in creating an entry site. The clinical causes of medial degeneration include hypertension, aortic aneurysms, obstructive sleep apnea, and connective tissue disorders. Second, mechanical wall stress is supposedly induced by shear stress caused by blood flow, together with hypertension and aortic root movement. Further investigation is necessary in the search for mechanisms responsible for medial degeneration prior to AD development. […] The clinical causes of medial degeneration include hypertension, aortic aneurysms, obstructive sleep apnea, and connective tissue disorders. […] Mechanical wall stress is supposedly induced by shear stress caused by blood flow, together with hypertension and aortic root movement.

• #12 Acute aortic dissection: pathogenesis, risk factors and diagnosis

  https://smw.ch/index.php/smw/article/download/2356/3595?inline=1

  Acute aortic dissection is a rare but life-threatening condition with a lethality rate of 1 to 2% per hour after onset of symptoms in untreated patients. […] Advanced age, male gender, long-term history of arterial hypertension and the presence of aortic aneurysm confer the greatest population attributable risk. […] However, patients with genetic connective tissue disorders such as Marfan, Loeys Dietz or Ehlers Danlos syndrome, and patients with bicuspid aortic valves are at the increased risk of aortic dissection at a much younger age. […] Aortic dissection arises from a tear in the aortic intima exposing the medial layer to the pulsatile blood flow. […] At the molecular level, aortic dissection is the result of remodelling of the aortic wall structure as a result of inflammation and extracellular matrix degradation.

• #13

• #14 Aortic Dissection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441963/

  Predisposing high-risk factors for nontraumatic aortic dissection include: […] Hypertension (occurs in 70% of patients with distal Stanford type B dissections) […] An abrupt, transient, severe increase in blood pressure (eg, strenuous weight lifting and use of sympathomimetic agents such as cocaine, ecstasy, or energy drinks) […] Genetic conditions include: Marfan syndrome […] In an International Registry of Acute Aortic Dissection (IRAD) review, Marfan syndrome was present in 50% of those younger than 40, compared with only 2% of older patients. […] In patients with Marfan syndrome, cystic medial necrosis is seen in the tissues. […] Ehlers-Danlos syndrome […] Turner syndrome […] Bicuspid aortic valve […] Coarctation of the aorta […] Preexisting aortic aneurysm […] Atherosclerosis

• #15 Aortic Dissection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441963/

  Predisposing high-risk factors for nontraumatic aortic dissection include: […] Hypertension (occurs in 70% of patients with distal Stanford type B dissections) […] An abrupt, transient, severe increase in blood pressure (eg, strenuous weight lifting and use of sympathomimetic agents such as cocaine, ecstasy, or energy drinks) […] Genetic conditions include: Marfan syndrome […] In an International Registry of Acute Aortic Dissection (IRAD) review, Marfan syndrome was present in 50% of those younger than 40, compared with only 2% of older patients. […] In patients with Marfan syndrome, cystic medial necrosis is seen in the tissues. […] Ehlers-Danlos syndrome […] Turner syndrome […] Bicuspid aortic valve […] Coarctation of the aorta […] Preexisting aortic aneurysm […] Atherosclerosis

• #16 Aortic Dissection: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/2062452-overview

  Congenital and acquired factors, alone or in combination, can lead to aortic dissection. Aortic dissection is more common in patients with hypertension, connective tissue disorders, congenital aortic stenosis, or a bicuspid aortic valve, as well as in those with first-degree relatives with a history of thoracic dissection. These diseases affect the media of the aorta and predispose it to dissection. […] Arterial hypertension is an important predisposing factor for aortic dissection. Of patients with aortic dissection, 70% have elevated blood pressure. Hypertension or pulsatile blood flow can propagate the dissection. […] Pregnancy can be a risk factor for aortic dissection, particularly in patients with an underlying anomaly such as Marfan syndrome. An estimated 50% of all cases of aortic dissection that occur in women younger than 40 years are associated with pregnancy. Most cases occur in the third trimester or early postpartum period.

• #17 Aortic dissection – Wikipedia

  https://en.wikipedia.org/wiki/Aortic_dissection

  Aortic dissection is associated with hypertension (high blood pressure) and many connective tissue disorders. […] About 72 to 80% of individuals who present with an aortic dissection have a previous history of hypertension. […] Illicit drug use with stimulants such as cocaine and methamphetamine is also a modifiable risk factor for AD. […] It can also be caused by smoking. […] A bicuspid aortic valve (a type of congenital heart disease involving the aortic valve) is found in 7-14% of individuals who have an aortic dissection. […] Connective tissue disorders such as Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome increase the risk of aortic dissection. […] Similarly, vasculitides such as Takayasu’s arteritis, giant cell arteritis, polyarteritis nodosa, and Behçet’s disease have been associated with a subsequent aortic dissection.

• #18 Aortic Dissection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441963/

  Predisposing high-risk factors for nontraumatic aortic dissection include: […] Hypertension (occurs in 70% of patients with distal Stanford type B dissections) […] An abrupt, transient, severe increase in blood pressure (eg, strenuous weight lifting and use of sympathomimetic agents such as cocaine, ecstasy, or energy drinks) […] Genetic conditions include: Marfan syndrome […] In an International Registry of Acute Aortic Dissection (IRAD) review, Marfan syndrome was present in 50% of those younger than 40, compared with only 2% of older patients. […] In patients with Marfan syndrome, cystic medial necrosis is seen in the tissues. […] Ehlers-Danlos syndrome […] Turner syndrome […] Bicuspid aortic valve […] Coarctation of the aorta […] Preexisting aortic aneurysm […] Atherosclerosis

• #19 Aortic Dissections: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/heart/aortic-aneurysm/aortic-dissections

  Aortic valve defects. Certain heart conditions such as bicuspid valve can provoke aortic dissection […] Genetic disorders – Marfan syndrome and Ehlers-Danlos syndrome are genetic conditions that can affect the structure and strength of the aortic walls […] Causes of Type B aortic dissection […] High blood pressure (Hypertension) – The most common cause of type B aortic dissection is hypertension […] Age – Men in their 60s and 70s are more prone to aortic dissection […] Atherosclerosis – Cardiovascular disease causes the arteries to harden, hindering their ability to pump blood […] Injury – A traumatic injury to the chest can cause aortic dissection […] Genetic disorders – Certain genetic diseases can predispose a person to aortic.

• #20 Aortic Dissection: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/2062452-overview

  Congenital and acquired factors, alone or in combination, can lead to aortic dissection. Aortic dissection is more common in patients with hypertension, connective tissue disorders, congenital aortic stenosis, or a bicuspid aortic valve, as well as in those with first-degree relatives with a history of thoracic dissection. These diseases affect the media of the aorta and predispose it to dissection. […] Arterial hypertension is an important predisposing factor for aortic dissection. Of patients with aortic dissection, 70% have elevated blood pressure. Hypertension or pulsatile blood flow can propagate the dissection. […] Pregnancy can be a risk factor for aortic dissection, particularly in patients with an underlying anomaly such as Marfan syndrome. An estimated 50% of all cases of aortic dissection that occur in women younger than 40 years are associated with pregnancy. Most cases occur in the third trimester or early postpartum period.

• #21 Risk Factors for Aortic Dissection | USC Journal

  https://www.uscjournal.com/articles/risk-factors-aortic-dissection?language_content_entity=en

  Aortic dissection is a critical condition, which can affect the aorta over its entire length. […] Aortic dissection has a wide range of risk factors that contribute to it being one of the most serious of cardiovascular conditions. […] Understanding the risk factors for AD is important for disease management. […] The incidence of AD is higher in older patients than in younger patients. […] In young patients, AD is typically associated with connective tissue disorders (CTDs), such as Marfan syndrome (MFS), Ehlers-Danlos syndrome (EDS), and Loeys-Dietz syndrome (LDS). […] In older patients, it is most often associated with underlying cardiovascular diseases (CVDs), such as atherosclerosis and hypertension, and aneurysms. […] Aneurysm is characterized by artery dilation of at least 1.5 times the normal size.

• #22 Aortic Dissection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441963/

  Predisposing high-risk factors for nontraumatic aortic dissection include: […] Hypertension (occurs in 70% of patients with distal Stanford type B dissections) […] An abrupt, transient, severe increase in blood pressure (eg, strenuous weight lifting and use of sympathomimetic agents such as cocaine, ecstasy, or energy drinks) […] Genetic conditions include: Marfan syndrome […] In an International Registry of Acute Aortic Dissection (IRAD) review, Marfan syndrome was present in 50% of those younger than 40, compared with only 2% of older patients. […] In patients with Marfan syndrome, cystic medial necrosis is seen in the tissues. […] Ehlers-Danlos syndrome […] Turner syndrome […] Bicuspid aortic valve […] Coarctation of the aorta […] Preexisting aortic aneurysm […] Atherosclerosis

• #23 Aortic Dissection: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/2062452-overview

  Cystic medial necrosis is the hallmark histologic change associated with dissection in those with Marfan syndrome. […] Iatrogenic aortic dissection can result from cardiologic procedures such as aortic and mitral valve replacements, coronary artery bypass graft surgery, and percutaneous catheter placement. Aortic dissection occurs when the layers are split in the process of cannulation or aortotomy. […] In late 2018, the US Food and Drug Administration (FDA) issued a warning that fluoroquinolone antibiotics can increase the occurrence of aortic dissections and suggested that unless other treatment options are unavailable, these agents should not be used in patients at increased risk, including those with a history of blockages or aneurysms of the aorta or other blood vessels, those with high blood pressure, those with certain genetic disorders that involve blood vessel changes, and the elderly.

• #24 Aortic Dissection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441963/

  Predisposing high-risk factors for nontraumatic aortic dissection include: […] Hypertension (occurs in 70% of patients with distal Stanford type B dissections) […] An abrupt, transient, severe increase in blood pressure (eg, strenuous weight lifting and use of sympathomimetic agents such as cocaine, ecstasy, or energy drinks) […] Genetic conditions include: Marfan syndrome […] In an International Registry of Acute Aortic Dissection (IRAD) review, Marfan syndrome was present in 50% of those younger than 40, compared with only 2% of older patients. […] In patients with Marfan syndrome, cystic medial necrosis is seen in the tissues. […] Ehlers-Danlos syndrome […] Turner syndrome […] Bicuspid aortic valve […] Coarctation of the aorta […] Preexisting aortic aneurysm […] Atherosclerosis

• #25 Acute Aortic Dissection • LITFL • CCC Cardiology

  https://litfl.com/acute-aortic-dissection/

  the most common catastrophe of the aorta (3:100,000); 3 times more common than abdominal aortic aneurysm (AAA) rupture […] aortic dissection is a type of acute aortic syndrome (AAS) characterized by blood entering the medial layer of the wall with the creation of a false lumen. […] There are 3 possibilities as to how the blood enters the media: Atherosclerotic ulcer leading to intimal tear […] Disruption of vasa vasorum causing intramural haematoma […] De novo intimal tear […] Hypertension (72% (and other CV risk factors: smoker, lipids)) […] infection (syphilis) […] arteritis such as Takayasus or giant cell […] aortic dilatation / aneurysm […] wall thinning […] crack cocaine (abrupt catecholamine-induced hypertension) […] Inherited disease (especially younger patients 40 yrs) […] Marfans syndrome (fibrillin gene mutations) […] Ehlers-Danlos syndrome type IV (collagen defects) […] Turner syndrome […] annulo- aortic ectasia […] familial aortic dissection.

• #26 Acute aortic dissection: pathogenesis, risk factors and diagnosis

  https://smw.ch/index.php/smw/article/download/2356/3595?inline=1

  Acute aortic dissection is a rare but life-threatening condition with a lethality rate of 1 to 2% per hour after onset of symptoms in untreated patients. […] Advanced age, male gender, long-term history of arterial hypertension and the presence of aortic aneurysm confer the greatest population attributable risk. […] However, patients with genetic connective tissue disorders such as Marfan, Loeys Dietz or Ehlers Danlos syndrome, and patients with bicuspid aortic valves are at the increased risk of aortic dissection at a much younger age. […] Aortic dissection arises from a tear in the aortic intima exposing the medial layer to the pulsatile blood flow. […] At the molecular level, aortic dissection is the result of remodelling of the aortic wall structure as a result of inflammation and extracellular matrix degradation.

• #27 Aortic dissection – Wikipedia

  https://en.wikipedia.org/wiki/Aortic_dissection

  Turner syndrome also increases the risk of aortic dissection, by aortic root dilatation. […] Chest trauma leading to aortic dissection can be divided into two groups based on cause: blunt chest trauma (commonly seen in car accidents) and iatrogenic. […] Aortic dissection may be a late sequela of heart surgery. […] Syphilis only potentially causes aortic dissection in its tertiary stage.

• #28 Risk Factors for Aortic Dissection | USC Journal

  https://www.uscjournal.com/articles/risk-factors-aortic-dissection?language_content_entity=en

  Thoracic AA is the most dangerous type of AA, not only because of the location (the aortic root), but also because it can evolve into dissection. […] CTDs are a group of congenital disorders responsible for the malformation of blood vessels, leading to their weakness. […] The risk of developing acute AD is amplified with MFS. […] The risk of AD is more severe in TS than in the general population and the AD occurs at a young age. […] Hypertension contributes to the deterioration of arterial walls. […] Tobacco smoking accelerates atherosclerosis and is a major risk factor for aortic aneurysms and dissections. […] Aortic smooth muscle cells are the main components of the tunica media and are responsible for aortic wall integrity and arterial wall remodeling. […] Compared with healthy people, those with obesity are more predisposed to develop acute AD.

• #29 Aortic Dissection: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/2062452-overview

  Congenital and acquired factors, alone or in combination, can lead to aortic dissection. Aortic dissection is more common in patients with hypertension, connective tissue disorders, congenital aortic stenosis, or a bicuspid aortic valve, as well as in those with first-degree relatives with a history of thoracic dissection. These diseases affect the media of the aorta and predispose it to dissection. […] Arterial hypertension is an important predisposing factor for aortic dissection. Of patients with aortic dissection, 70% have elevated blood pressure. Hypertension or pulsatile blood flow can propagate the dissection. […] Pregnancy can be a risk factor for aortic dissection, particularly in patients with an underlying anomaly such as Marfan syndrome. An estimated 50% of all cases of aortic dissection that occur in women younger than 40 years are associated with pregnancy. Most cases occur in the third trimester or early postpartum period.

• #30 Aortic dissection – Wikipedia

  https://en.wikipedia.org/wiki/Aortic_dissection

  Aortic dissection is associated with hypertension (high blood pressure) and many connective tissue disorders. […] About 72 to 80% of individuals who present with an aortic dissection have a previous history of hypertension. […] Illicit drug use with stimulants such as cocaine and methamphetamine is also a modifiable risk factor for AD. […] It can also be caused by smoking. […] A bicuspid aortic valve (a type of congenital heart disease involving the aortic valve) is found in 7-14% of individuals who have an aortic dissection. […] Connective tissue disorders such as Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome increase the risk of aortic dissection. […] Similarly, vasculitides such as Takayasu’s arteritis, giant cell arteritis, polyarteritis nodosa, and Behçet’s disease have been associated with a subsequent aortic dissection.

• #31 Acute aortic dissection: pathogenesis, risk factors and diagnosis

  https://smw.ch/index.php/smw/article/download/2356/3595?inline=1

  Arterial hypertension is, as described below, one of the main risk factors for aortic dissection. […] So far several risk factors for developing aortic dissection are recognised. […] Hypertension is considered as the most important risk factor for aortic dissection and is present in about 80% of patients with aortic dissection. […] Smoking is another risk factor for developing aneurysm and aortic dissection. […] Marfan syndrome and other inherited connective tissue diseases, such as vascular-type Ehlers-Danlos syndrome or Loeys-Dietz syndrome, are associated with aortic dissection especially in young patients. […] Congenital bicuspid aortic valve is the most common cardiovascular malformation, occurring in 1 to 2% of the general population, and is a risk factor for aortic aneurysm and dissection.

• #32 Aortic Dissection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441963/

  Predisposing high-risk factors for nontraumatic aortic dissection include: […] Hypertension (occurs in 70% of patients with distal Stanford type B dissections) […] An abrupt, transient, severe increase in blood pressure (eg, strenuous weight lifting and use of sympathomimetic agents such as cocaine, ecstasy, or energy drinks) […] Genetic conditions include: Marfan syndrome […] In an International Registry of Acute Aortic Dissection (IRAD) review, Marfan syndrome was present in 50% of those younger than 40, compared with only 2% of older patients. […] In patients with Marfan syndrome, cystic medial necrosis is seen in the tissues. […] Ehlers-Danlos syndrome […] Turner syndrome […] Bicuspid aortic valve […] Coarctation of the aorta […] Preexisting aortic aneurysm […] Atherosclerosis

• #33

  https://www2.hse.ie/conditions/aortic-dissection/causes-of-aortic-dissection/

  Aortic dissection happens because of weakness in the aortic wall. There’s no one reason why this weakness happens. […] High blood pressure over a long period of time may weaken the wall of the aorta, making it more likely to tear. […] Some people are born with a condition that causes a weakened wall of the aorta. […] There is an increased risk of aortic dissection if you already have an enlarged aorta (aortic aneurysm). […] There is an increased risk of aortic dissection if you have a history of aortic diseases in your family. […] There is an increased risk of an aortic dissection if you are 6 months or more pregnant. But it is very rare.

• #34 Aortic Dissection vs. Aneurysm: How Do They Differ?

  https://www.healthline.com/health/aortic-dissection-vs-aneurysm

  An aortic dissection happens when there is a tear in the innermost wall of the aorta and blood pushes between the inner and outer walls, separating them. […] Like aortic aneurysms, aortic dissections can be caused by weakened aortic walls. As a result, the risk factors for both conditions are similar. […] Yes, an aortic aneurysm increases your risk of an aortic dissection. […] If you have an aneurysm, it means the walls of your aorta are already weakened and stretched. This makes the aorta more vulnerable to a tear that could lead to an aortic dissection. […] Sometimes an aortic dissection is the first sign of an asymptomatic aortic aneurysm.

• #35 Aortic dissection | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/aortic-dissection?lang=us

  Causes include: hypertension (pathogenesis: medial degeneration), inherited connective tissue disorders (pathogenesis: medial degeneration), atherosclerosis (pathogenesis: penetrating ulcer), vasculitis (pathogenesis: inflammation), pregnancy (pathogenesis: unknown), and iatrogenic causes such as aortic catheterization and intra-aortic balloon pump.

• #36 Aortic Dissection – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/diseases-of-the-aorta-and-its-branches/aortic-dissection

  Aortic dissections often occur in patients with preexisting degeneration of the aortic media. Causes and risk factors include connective tissue disorders, atherosclerotic disease, systemic rheumatic diseases, and injury. […] Atherosclerotic risk factors, notably hypertension, contribute in more than two-thirds of patients. After rupture of the intima, which is a primary event in some patients and secondary to hemorrhage within the media in others, blood flows into the media, creating a false channel that extends distally or, less commonly, proximally along the artery.

• #37 Acute aortic dissection: pathogenesis, risk factors and diagnosis

  https://smw.ch/index.php/smw/article/download/2356/3595?inline=1

  Arterial hypertension is, as described below, one of the main risk factors for aortic dissection. […] So far several risk factors for developing aortic dissection are recognised. […] Hypertension is considered as the most important risk factor for aortic dissection and is present in about 80% of patients with aortic dissection. […] Smoking is another risk factor for developing aneurysm and aortic dissection. […] Marfan syndrome and other inherited connective tissue diseases, such as vascular-type Ehlers-Danlos syndrome or Loeys-Dietz syndrome, are associated with aortic dissection especially in young patients. […] Congenital bicuspid aortic valve is the most common cardiovascular malformation, occurring in 1 to 2% of the general population, and is a risk factor for aortic aneurysm and dissection.

• #38 Aortic Dissection: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/2062452-overview

  Congenital and acquired factors, alone or in combination, can lead to aortic dissection. Aortic dissection is more common in patients with hypertension, connective tissue disorders, congenital aortic stenosis, or a bicuspid aortic valve, as well as in those with first-degree relatives with a history of thoracic dissection. These diseases affect the media of the aorta and predispose it to dissection. […] Arterial hypertension is an important predisposing factor for aortic dissection. Of patients with aortic dissection, 70% have elevated blood pressure. Hypertension or pulsatile blood flow can propagate the dissection. […] Pregnancy can be a risk factor for aortic dissection, particularly in patients with an underlying anomaly such as Marfan syndrome. An estimated 50% of all cases of aortic dissection that occur in women younger than 40 years are associated with pregnancy. Most cases occur in the third trimester or early postpartum period.

• #39 Aortic Dissections: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/heart/aortic-aneurysm/aortic-dissections

  What causes aortic dissections? […] Aortic dissection begins when the cells that make up the aorta start to break down. It can take many years before the weakened section of the aorta finally tears or ruptures. […] Doctors believe some people are born with an inherited trait for the propensity of weakened aortic walls. Other people can develop a weakened aorta from years of constant high blood pressure. Eventually, the aortic wall will become too weak, resulting in a tear called aortic dissection. […] Causes of Type A aortic dissection […] Age – Aortic dissection is more common in males over the age of 60 […] High blood pressure for many years can weaken the aortic wall […] Fatty plaque from high cholesterol can block the artery or break off, causing a blood clot […] Bulge in the aorta – A blood clot can cause a bulge, which could possibly rupture

• #40 Aortic Dissection Symptoms, Causes. Heart Conditions – Heart Foundation NZ

  https://www.heartfoundation.org.nz/your-heart/heart-conditions/aortic-dissection

  An aortic dissection usually occurs when there is a weakness in the wall of the aorta. There are a number of known aortic dissection risk factors. These include: […] Chronic high blood pressure (hypertension) – It is thought that ongoing high blood pressure may stress the aortic tissue, making it more likely to tear […] Coronary artery disease (atherosclerosis) – Hardened arteries increase the pressure on the aorta […] Smoking […] Aortic valve defect (heart valve disease) […] Aortic aneurysm […] Congenital heart disease – Some people are born with heart conditions that make an aortic dissection more likely. These include bicuspid aortic valve (an aortic valve defect), Marfan syndrome and Ehlers-Danlos syndrome (both connective tissue disorders) […] Family – Aortic dissection may be more likely if there is a history of aortic dissection in your family

• #41 Aortic dissection: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000181.htm

  Aortic dissection most often happens because of a tear or damage to the inner wall of the aorta. This very often occurs in the chest (thoracic) part of the artery, but it may also occur in the abdominal aorta. […] The exact cause is unknown, but more common risks include: […] Other risk factors and conditions linked to aortic dissection include: […] Aortic dissection occurs in about 2 out of every 10,000 people. It can affect anyone, but is most often seen in men ages 40 to 70.

• #42 Aortic Dissections: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/heart/aortic-aneurysm/aortic-dissections

  What causes aortic dissections? […] Aortic dissection begins when the cells that make up the aorta start to break down. It can take many years before the weakened section of the aorta finally tears or ruptures. […] Doctors believe some people are born with an inherited trait for the propensity of weakened aortic walls. Other people can develop a weakened aorta from years of constant high blood pressure. Eventually, the aortic wall will become too weak, resulting in a tear called aortic dissection. […] Causes of Type A aortic dissection […] Age – Aortic dissection is more common in males over the age of 60 […] High blood pressure for many years can weaken the aortic wall […] Fatty plaque from high cholesterol can block the artery or break off, causing a blood clot […] Bulge in the aorta – A blood clot can cause a bulge, which could possibly rupture

• #43 Aortic Dissection Symptoms, Causes. Heart Conditions – Heart Foundation NZ

  https://www.heartfoundation.org.nz/your-heart/heart-conditions/aortic-dissection

  Gender – Twice as many men have aortic dissection as women […] Age – Aortic dissection is more common in people over 60 […] Pregnancy – Occasionally aortic dissection can occur in pregnant women […] Cocaine use – This can increase risk of aortic dissection because of a temporary rise in blood pressure […] Strenuous weightlifting exercises – Again, a temporary rise in blood pressure which occurs during very strenuous weightlifting may increase the risk of aortic dissection […] Traumatic injury to the chest area.

• #44 Familial aortic dissection – Wikipedia

  https://en.wikipedia.org/wiki/Familial_aortic_dissection

  Still other studies show that mutations in smooth muscle cell-specific isoforms of alpha actin and beta myosin heavy chain may cause FAD. […] Mutations in the genes TGFBR 1 and 2 are known to cause dissections in aortas with normal diameter size (4.3 cm) and gene FPN1 mutations typically affect aortas with larger diameters (4.4 cm). […] The major risk factors for FAD include high blood pressure, old age, haematoma, genetic weakening of aortic wall, cocaine use, pregnancy and diseases causing abnormal connective tissue. […] One study found that the average age(s) for the occurrence of dissection caused by degenerative aneurysm is 65 years and up. Dissections thought to be the result of genetic mutations appear to be more likely to occur between the ages of 40 and 60. […] Another study found that 20% of patients with FAD have a close relative with a history of thoracic aortic aneurysm or dissection which suggests yet another major risk factor.

• #45 Aortic dissection – Wikipedia

  https://en.wikipedia.org/wiki/Aortic_dissection

  Turner syndrome also increases the risk of aortic dissection, by aortic root dilatation. […] Chest trauma leading to aortic dissection can be divided into two groups based on cause: blunt chest trauma (commonly seen in car accidents) and iatrogenic. […] Aortic dissection may be a late sequela of heart surgery. […] Syphilis only potentially causes aortic dissection in its tertiary stage.

• #46 Aortic Dissection: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/2062452-overview

  Cystic medial necrosis is the hallmark histologic change associated with dissection in those with Marfan syndrome. […] Iatrogenic aortic dissection can result from cardiologic procedures such as aortic and mitral valve replacements, coronary artery bypass graft surgery, and percutaneous catheter placement. Aortic dissection occurs when the layers are split in the process of cannulation or aortotomy. […] In late 2018, the US Food and Drug Administration (FDA) issued a warning that fluoroquinolone antibiotics can increase the occurrence of aortic dissections and suggested that unless other treatment options are unavailable, these agents should not be used in patients at increased risk, including those with a history of blockages or aneurysms of the aorta or other blood vessels, those with high blood pressure, those with certain genetic disorders that involve blood vessel changes, and the elderly.

• #47 Aortic Dissection: Types, Causes, Warning Signs, Treatment

  https://www.medicinenet.com/aortic_dissection/article.htm

  Blunt trauma is known to cause aortic dissection, which is often seen after car wrecks in which the patient’s chest hits the steering wheel. […] Aortic dissection can be a complication of medical operations including coronary artery bypass grafting and aortic and mitral valve repairs. It can also be a complication of heart catheterization.

• #48 Aortic Dissection: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/2062452-overview

  Cystic medial necrosis is the hallmark histologic change associated with dissection in those with Marfan syndrome. […] Iatrogenic aortic dissection can result from cardiologic procedures such as aortic and mitral valve replacements, coronary artery bypass graft surgery, and percutaneous catheter placement. Aortic dissection occurs when the layers are split in the process of cannulation or aortotomy. […] In late 2018, the US Food and Drug Administration (FDA) issued a warning that fluoroquinolone antibiotics can increase the occurrence of aortic dissections and suggested that unless other treatment options are unavailable, these agents should not be used in patients at increased risk, including those with a history of blockages or aneurysms of the aorta or other blood vessels, those with high blood pressure, those with certain genetic disorders that involve blood vessel changes, and the elderly.

• #49 Aortic dissection – Wikipedia

  https://en.wikipedia.org/wiki/Aortic_dissection

  Aortic dissection is associated with hypertension (high blood pressure) and many connective tissue disorders. […] About 72 to 80% of individuals who present with an aortic dissection have a previous history of hypertension. […] Illicit drug use with stimulants such as cocaine and methamphetamine is also a modifiable risk factor for AD. […] It can also be caused by smoking. […] A bicuspid aortic valve (a type of congenital heart disease involving the aortic valve) is found in 7-14% of individuals who have an aortic dissection. […] Connective tissue disorders such as Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome increase the risk of aortic dissection. […] Similarly, vasculitides such as Takayasu’s arteritis, giant cell arteritis, polyarteritis nodosa, and Behçet’s disease have been associated with a subsequent aortic dissection.

• #50 Aortic Dissection: Symptoms, Causes, Treatment, Prevention

  https://www.webmd.com/heart-disease/what-is-aortic-dissection

  Aortic dissections happen in places where your aortic wall is weak. Over time, high blood pressure can weaken your aortic tissue. […] Sometimes the weakness is from a condition youre born with that affects the strength or size of your aorta. Marfan syndrome is one example. […] In rare cases it results from a traumatic injury to the chest, like youd get in a car accident. […] Aortic dissections most often affect men between the ages of 60 and 80. Men are twice as likely to have an aortic dissection as women. Other things that make an aortic dissection more likely include: […] Certain genetic diseases also seem to increase your odds of having an aortic dissection, including: […] Using cocaine, being pregnant, and even high-intensity weightlifting can raise your chances of having an aortic dissection. Its mostly likely if you already have a history of blood pressure or blood vessel problems.

• #51 Risk Factors for Aortic Dissection | USC Journal

  https://www.uscjournal.com/articles/risk-factors-aortic-dissection?language_content_entity=en

  There is a risk of AD developing during or immediately following pregnancy. […] Sildenafil became the first oral pill for erectile dysfunction in the US. […] However, some cases of AD have been associated with sildenafil, because it is a vasodilator and can decrease aortic stiffness. […] Cocaine is listed among both predisposing and aggravating factors for AD. […] Iatrogenic AD (IAD) is the presence of AD as a complication of a cardiac procedure. […] Understanding the risk factors for AD may contribute to the slowing down of progression, limiting complications of the disease, and improving patient prognosis.

• #52 Risk Factors for Aortic Dissection | USC Journal

  https://www.uscjournal.com/articles/risk-factors-aortic-dissection?language_content_entity=en

  Thoracic AA is the most dangerous type of AA, not only because of the location (the aortic root), but also because it can evolve into dissection. […] CTDs are a group of congenital disorders responsible for the malformation of blood vessels, leading to their weakness. […] The risk of developing acute AD is amplified with MFS. […] The risk of AD is more severe in TS than in the general population and the AD occurs at a young age. […] Hypertension contributes to the deterioration of arterial walls. […] Tobacco smoking accelerates atherosclerosis and is a major risk factor for aortic aneurysms and dissections. […] Aortic smooth muscle cells are the main components of the tunica media and are responsible for aortic wall integrity and arterial wall remodeling. […] Compared with healthy people, those with obesity are more predisposed to develop acute AD.

• #53 Aortic Dissection Symptoms, Causes. Heart Conditions – Heart Foundation NZ

  https://www.heartfoundation.org.nz/your-heart/heart-conditions/aortic-dissection

  Gender – Twice as many men have aortic dissection as women […] Age – Aortic dissection is more common in people over 60 […] Pregnancy – Occasionally aortic dissection can occur in pregnant women […] Cocaine use – This can increase risk of aortic dissection because of a temporary rise in blood pressure […] Strenuous weightlifting exercises – Again, a temporary rise in blood pressure which occurs during very strenuous weightlifting may increase the risk of aortic dissection […] Traumatic injury to the chest area.

• #54 Aortic Dissection: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/2062452-overview

  Congenital and acquired factors, alone or in combination, can lead to aortic dissection. Aortic dissection is more common in patients with hypertension, connective tissue disorders, congenital aortic stenosis, or a bicuspid aortic valve, as well as in those with first-degree relatives with a history of thoracic dissection. These diseases affect the media of the aorta and predispose it to dissection. […] Arterial hypertension is an important predisposing factor for aortic dissection. Of patients with aortic dissection, 70% have elevated blood pressure. Hypertension or pulsatile blood flow can propagate the dissection. […] Pregnancy can be a risk factor for aortic dissection, particularly in patients with an underlying anomaly such as Marfan syndrome. An estimated 50% of all cases of aortic dissection that occur in women younger than 40 years are associated with pregnancy. Most cases occur in the third trimester or early postpartum period.

• #55 Aortic Dissection: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/2062452-overview

  Congenital and acquired factors, alone or in combination, can lead to aortic dissection. Aortic dissection is more common in patients with hypertension, connective tissue disorders, congenital aortic stenosis, or a bicuspid aortic valve, as well as in those with first-degree relatives with a history of thoracic dissection. These diseases affect the media of the aorta and predispose it to dissection. […] Arterial hypertension is an important predisposing factor for aortic dissection. Of patients with aortic dissection, 70% have elevated blood pressure. Hypertension or pulsatile blood flow can propagate the dissection. […] Pregnancy can be a risk factor for aortic dissection, particularly in patients with an underlying anomaly such as Marfan syndrome. An estimated 50% of all cases of aortic dissection that occur in women younger than 40 years are associated with pregnancy. Most cases occur in the third trimester or early postpartum period.

• #56 Aortic Dissection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441963/

  Pregnancy and delivery […] This risk is compounded in pregnant women with connective tissue disorders such as Marfan syndrome. […] Family history […] Aortic instrumentation or surgery (eg, coronary artery bypass, aortic or mitral valve replacement, and percutaneous stenting or catheter insertion) […] Inflammatory or infectious diseases that cause vasculitis (eg, syphilis, cocaine use).

• #57 Aortic Dissection Explained Risk Factors, Symptoms, Diagnosis, FAQs

  https://aorticdissectioncharitabletrust.org/about-aortic-dissection/

  Aortic dissection is caused by a partial tear in the wall of the aorta. This tear then spreads along the length of the aorta. […] High blood pressure is an important cause of aortic dissection, and to reduce the risks of complications, it is extremely important that high blood pressure is well controlled. […] The most common cause of aortic dissections is high blood pressure. Other possible causes of aortic dissections include a congenital heart defect, certain infections, connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome, a trauma-related injury to the aorta, and drug abuse. […] Aortic dissection can affect adults of any age. It is an important cause of maternal death. […] 11% of maternal deaths from cardiovascular causes are due to aortic dissection.

• #58 Aortic dissection – Wikipedia

  https://en.wikipedia.org/wiki/Aortic_dissection

  Aortic dissection is associated with hypertension (high blood pressure) and many connective tissue disorders. […] About 72 to 80% of individuals who present with an aortic dissection have a previous history of hypertension. […] Illicit drug use with stimulants such as cocaine and methamphetamine is also a modifiable risk factor for AD. […] It can also be caused by smoking. […] A bicuspid aortic valve (a type of congenital heart disease involving the aortic valve) is found in 7-14% of individuals who have an aortic dissection. […] Connective tissue disorders such as Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome increase the risk of aortic dissection. […] Similarly, vasculitides such as Takayasu’s arteritis, giant cell arteritis, polyarteritis nodosa, and Behçet’s disease have been associated with a subsequent aortic dissection.

• #59 Aortic dissection – Wikipedia

  https://en.wikipedia.org/wiki/Aortic_dissection

  Aortic dissection is associated with hypertension (high blood pressure) and many connective tissue disorders. […] About 72 to 80% of individuals who present with an aortic dissection have a previous history of hypertension. […] Illicit drug use with stimulants such as cocaine and methamphetamine is also a modifiable risk factor for AD. […] It can also be caused by smoking. […] A bicuspid aortic valve (a type of congenital heart disease involving the aortic valve) is found in 7-14% of individuals who have an aortic dissection. […] Connective tissue disorders such as Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome increase the risk of aortic dissection. […] Similarly, vasculitides such as Takayasu’s arteritis, giant cell arteritis, polyarteritis nodosa, and Behçet’s disease have been associated with a subsequent aortic dissection.

• #60 Aortic dissection – Wikipedia

  https://en.wikipedia.org/wiki/Aortic_dissection

  Turner syndrome also increases the risk of aortic dissection, by aortic root dilatation. […] Chest trauma leading to aortic dissection can be divided into two groups based on cause: blunt chest trauma (commonly seen in car accidents) and iatrogenic. […] Aortic dissection may be a late sequela of heart surgery. […] Syphilis only potentially causes aortic dissection in its tertiary stage.

• #61 Aortic Dissection

  https://aci.health.nsw.gov.au/networks/eci/clinical/tools/cardiology/aortic-dissection

  Aortic dissection occurs when blood enters the medial layer of the aortic wall, creating a false lumen. […] Risk factors include cocaine use, Marfan syndrome, connective tissue disease, family history of aortic disease, recent aortic manipulation, known thoracic aortic aneurysm, and known aortic valve disease. […] The D-dimer will be elevated in nearly all aortic dissection, the only exception is when the dissection starts as an intra-mural haematoma.

• #62

  https://link.springer.com/article/10.1007/s11748-019-01066-x

  We discuss the etiology of aortic dissection (AD) from various points of view. The development of AD requires two pathological conditions: medial degeneration and mechanical wall stress. First, histopathological findings of medial degeneration are hypothesized to be due to a loss of elastic fibers and interconnecting elastic fibers. Damage to the vasa vasorum plays a key role in creating an entry site. The clinical causes of medial degeneration include hypertension, aortic aneurysms, obstructive sleep apnea, and connective tissue disorders. Second, mechanical wall stress is supposedly induced by shear stress caused by blood flow, together with hypertension and aortic root movement. Further investigation is necessary in the search for mechanisms responsible for medial degeneration prior to AD development. […] The clinical causes of medial degeneration include hypertension, aortic aneurysms, obstructive sleep apnea, and connective tissue disorders. […] Mechanical wall stress is supposedly induced by shear stress caused by blood flow, together with hypertension and aortic root movement.

• #63 Risk Factors for Aortic Dissection | USC Journal

  https://www.uscjournal.com/articles/risk-factors-aortic-dissection?language_content_entity=en

  Thoracic AA is the most dangerous type of AA, not only because of the location (the aortic root), but also because it can evolve into dissection. […] CTDs are a group of congenital disorders responsible for the malformation of blood vessels, leading to their weakness. […] The risk of developing acute AD is amplified with MFS. […] The risk of AD is more severe in TS than in the general population and the AD occurs at a young age. […] Hypertension contributes to the deterioration of arterial walls. […] Tobacco smoking accelerates atherosclerosis and is a major risk factor for aortic aneurysms and dissections. […] Aortic smooth muscle cells are the main components of the tunica media and are responsible for aortic wall integrity and arterial wall remodeling. […] Compared with healthy people, those with obesity are more predisposed to develop acute AD.

• #64 Aortic Dissection: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/2062452-overview

  Cystic medial necrosis is the hallmark histologic change associated with dissection in those with Marfan syndrome. […] Iatrogenic aortic dissection can result from cardiologic procedures such as aortic and mitral valve replacements, coronary artery bypass graft surgery, and percutaneous catheter placement. Aortic dissection occurs when the layers are split in the process of cannulation or aortotomy. […] In late 2018, the US Food and Drug Administration (FDA) issued a warning that fluoroquinolone antibiotics can increase the occurrence of aortic dissections and suggested that unless other treatment options are unavailable, these agents should not be used in patients at increased risk, including those with a history of blockages or aneurysms of the aorta or other blood vessels, those with high blood pressure, those with certain genetic disorders that involve blood vessel changes, and the elderly.

• #65 Risk Factors for Aortic Dissection | USC Journal

  https://www.uscjournal.com/articles/risk-factors-aortic-dissection?language_content_entity=en

  There is a risk of AD developing during or immediately following pregnancy. […] Sildenafil became the first oral pill for erectile dysfunction in the US. […] However, some cases of AD have been associated with sildenafil, because it is a vasodilator and can decrease aortic stiffness. […] Cocaine is listed among both predisposing and aggravating factors for AD. […] Iatrogenic AD (IAD) is the presence of AD as a complication of a cardiac procedure. […] Understanding the risk factors for AD may contribute to the slowing down of progression, limiting complications of the disease, and improving patient prognosis.

• #66 Acute aortic dissection: pathogenesis, risk factors and diagnosis

  https://smw.ch/index.php/smw/article/download/2356/3595?inline=1

  Acute aortic dissection is a rare but life-threatening condition with a lethality rate of 1 to 2% per hour after onset of symptoms in untreated patients. […] Advanced age, male gender, long-term history of arterial hypertension and the presence of aortic aneurysm confer the greatest population attributable risk. […] However, patients with genetic connective tissue disorders such as Marfan, Loeys Dietz or Ehlers Danlos syndrome, and patients with bicuspid aortic valves are at the increased risk of aortic dissection at a much younger age. […] Aortic dissection arises from a tear in the aortic intima exposing the medial layer to the pulsatile blood flow. […] At the molecular level, aortic dissection is the result of remodelling of the aortic wall structure as a result of inflammation and extracellular matrix degradation.

• #67 Risk Factors for Aortic Dissection | USC Journal

  https://www.uscjournal.com/articles/risk-factors-aortic-dissection?language_content_entity=en

  Thoracic AA is the most dangerous type of AA, not only because of the location (the aortic root), but also because it can evolve into dissection. […] CTDs are a group of congenital disorders responsible for the malformation of blood vessels, leading to their weakness. […] The risk of developing acute AD is amplified with MFS. […] The risk of AD is more severe in TS than in the general population and the AD occurs at a young age. […] Hypertension contributes to the deterioration of arterial walls. […] Tobacco smoking accelerates atherosclerosis and is a major risk factor for aortic aneurysms and dissections. […] Aortic smooth muscle cells are the main components of the tunica media and are responsible for aortic wall integrity and arterial wall remodeling. […] Compared with healthy people, those with obesity are more predisposed to develop acute AD.

• #68

  https://step2.medbullets.com/cardiovascular/120030/aortic-dissection

  Aortic dissection is a condition that results from a tear in the innermost layer of the aorta leading to a hematoma and separation of layers of the aortic wall. […] Patients with hypertension and advanced age are more at risk for dissection. […] risk factors include hypertension, atherosclerosis, aortic aneurysm, Turner syndrome, Marfan syndrome, and Ehlers-Danos syndrome. […] an intimal tear of the aorta causes an intramural aortic hemorrhage that separates the intima from the media. […] the resulting hematoma may rupture through the adventitia, leading to a thoracic or abdominal cavity hemorrhage or cardiac tamponade. […] dissection involves fragility of the media layer of the aorta. […] Marfan syndrome results in cystic medial necrosis in the tissue of the aorta.

• #69 Familial aortic dissection – Wikipedia

  https://en.wikipedia.org/wiki/Familial_aortic_dissection

  Still other studies show that mutations in smooth muscle cell-specific isoforms of alpha actin and beta myosin heavy chain may cause FAD. […] Mutations in the genes TGFBR 1 and 2 are known to cause dissections in aortas with normal diameter size (4.3 cm) and gene FPN1 mutations typically affect aortas with larger diameters (4.4 cm). […] The major risk factors for FAD include high blood pressure, old age, haematoma, genetic weakening of aortic wall, cocaine use, pregnancy and diseases causing abnormal connective tissue. […] One study found that the average age(s) for the occurrence of dissection caused by degenerative aneurysm is 65 years and up. Dissections thought to be the result of genetic mutations appear to be more likely to occur between the ages of 40 and 60. […] Another study found that 20% of patients with FAD have a close relative with a history of thoracic aortic aneurysm or dissection which suggests yet another major risk factor.

• #70 Familial aortic dissection – Wikipedia

  https://en.wikipedia.org/wiki/Familial_aortic_dissection

  Still other studies show that mutations in smooth muscle cell-specific isoforms of alpha actin and beta myosin heavy chain may cause FAD. […] Mutations in the genes TGFBR 1 and 2 are known to cause dissections in aortas with normal diameter size (4.3 cm) and gene FPN1 mutations typically affect aortas with larger diameters (4.4 cm). […] The major risk factors for FAD include high blood pressure, old age, haematoma, genetic weakening of aortic wall, cocaine use, pregnancy and diseases causing abnormal connective tissue. […] One study found that the average age(s) for the occurrence of dissection caused by degenerative aneurysm is 65 years and up. Dissections thought to be the result of genetic mutations appear to be more likely to occur between the ages of 40 and 60. […] Another study found that 20% of patients with FAD have a close relative with a history of thoracic aortic aneurysm or dissection which suggests yet another major risk factor.

• #71 Familial aortic dissection – Wikipedia

  https://en.wikipedia.org/wiki/Familial_aortic_dissection

  Familial aortic dissection or FAD refers to the splitting of the wall of the aorta in either the arch, ascending or descending portions. FAD is thought to be passed down as an autosomal dominant disease and once inherited will result in dissection of the aorta, and dissecting aneurysm of the aorta, or rarely aortic or arterial dilation at a young age. […] The inheritance pattern of aortic dissection is multifactorial. There is a good amount of evidence that shows the disease is autosomal dominant, with some penetrance. There is also the possibility of age related dependence. It is known that Marfans Syndrome and Ehler-Danlos Syndrome lead to an increased risk for development of FAD. […] One study suggests that the chromosomal locus for the gene is 5q13-14. The same study found that other genes may be linked, and include loci for Marfan and Ehler-Danlos Syndromes, genes for metalloproteinase 3 and 9, and tissue inhibitor of malloproteinase 2 as well as two loci on chromosomes 5q13-14 and lq23.2-24.

• #72 Aortic Dissection: Causes, Symptoms & Treatment | Tampa General Hospital

  https://www.tgh.org/institutes-and-services/conditions/aortic-dissection-type-a-and-type-b

  The exact cause of aortic dissection is unknown, but more common risk factors include: […] Other risk factors and conditions linked to aortic dissection include: […] Many cases of aortic dissection cannot be prevented, but there are steps individuals can take to reduce their risk including:

• #73 Aortic Dissection Explained Risk Factors, Symptoms, Diagnosis, FAQs

  https://aorticdissectioncharitabletrust.org/about-aortic-dissection/

  Aortic dissection is caused by a partial tear in the wall of the aorta. This tear then spreads along the length of the aorta. […] High blood pressure is an important cause of aortic dissection, and to reduce the risks of complications, it is extremely important that high blood pressure is well controlled. […] The most common cause of aortic dissections is high blood pressure. Other possible causes of aortic dissections include a congenital heart defect, certain infections, connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome, a trauma-related injury to the aorta, and drug abuse. […] Aortic dissection can affect adults of any age. It is an important cause of maternal death. […] 11% of maternal deaths from cardiovascular causes are due to aortic dissection.

• #74 Acute aortic dissection: pathogenesis, risk factors and diagnosis

  https://smw.ch/index.php/smw/article/download/2356/3595?inline=1

  Arterial hypertension is, as described below, one of the main risk factors for aortic dissection. […] So far several risk factors for developing aortic dissection are recognised. […] Hypertension is considered as the most important risk factor for aortic dissection and is present in about 80% of patients with aortic dissection. […] Smoking is another risk factor for developing aneurysm and aortic dissection. […] Marfan syndrome and other inherited connective tissue diseases, such as vascular-type Ehlers-Danlos syndrome or Loeys-Dietz syndrome, are associated with aortic dissection especially in young patients. […] Congenital bicuspid aortic valve is the most common cardiovascular malformation, occurring in 1 to 2% of the general population, and is a risk factor for aortic aneurysm and dissection.

• #75 Aortic dissection | healthdirect

  https://www.healthdirect.gov.au/aortic-dissection

  An aortic dissection is when there is a tear in the wall of your aorta the largest blood vessel in your body. […] Aortic dissection is when there is a tear in the wall of your aorta. The tear can occur in an area of the aortic wall that is weak. […] You are more at risk of aortic dissection if you: have uncontrolled high blood pressure, have hardening of the arteries, have an aortic aneurysm, were born with a defect in your aorta or aortic heart valve, have had previous heart surgery or a heart procedure, have a family history of aortic disease. […] Some genetic conditions can increase your risk or aortic dissection. These include: Marfan syndrome, Ehlers-Danlos syndrome. […] Smoking, using cocaine and heavy lifting can also increase your risk.

• #76 Thoracic Aortic Aneurysm & Aortic Dissection | Marfan Foundation

  https://marfan.org/conditions/familial-aortic-aneurysm/

  Aortic enlargement (dilatation/aneurysm) is generally the main feature of this condition. Aortic dissection is a sudden tear of the inner wall of the aorta that allows blood to flow between the aortas inner and outer walls. This causes chest and/or back pain and can lead to aortic rupture. People may develop aneurysms or aortic dissections at any time in their lives. This condition can be inherited and, even within the same family, the occurrence and timing of these problems can vary. […] About 20 percent of people with thoracic aortic aneurysm and dissection have a genetic predisposition to it, meaning it runs in the family. This type is known as familial thoracic aneurysm and dissection. Many people dont know they have a genetic predisposition to thoracic aortic aneurysm and dissection. First-degree relatives (i.e., parents, children, siblings) of individuals known to have thoracic aortic aneurysm should be screened for the condition. […] A diagnosis of familial thoracic aortic aneurysm and dissection is made when there is a positive family history of aneurysm and dissection. […] There are many known genes to cause FTAAD but there are still many genes that need to be discovered.

• #77 Aortic dissection: Symptoms, types, causes, and treatment

  https://www.medicalnewstoday.com/articles/323435

  Less commonly, a severe chest injury may contribute to a tear in the aorta. […] Aortic dissections can occur during pregnancy in rare cases. […] Cocaine raises blood pressure, which increases a person’s risk of aortic dissection. […] Intense resistance training increases blood pressure, which may result in an aortic tear.

• #78 Aortic Dissection: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/2062452-overview

  Congenital and acquired factors, alone or in combination, can lead to aortic dissection. Aortic dissection is more common in patients with hypertension, connective tissue disorders, congenital aortic stenosis, or a bicuspid aortic valve, as well as in those with first-degree relatives with a history of thoracic dissection. These diseases affect the media of the aorta and predispose it to dissection. […] Arterial hypertension is an important predisposing factor for aortic dissection. Of patients with aortic dissection, 70% have elevated blood pressure. Hypertension or pulsatile blood flow can propagate the dissection. […] Pregnancy can be a risk factor for aortic dissection, particularly in patients with an underlying anomaly such as Marfan syndrome. An estimated 50% of all cases of aortic dissection that occur in women younger than 40 years are associated with pregnancy. Most cases occur in the third trimester or early postpartum period.

• #79 Acute aortic dissection: pathogenesis, risk factors and diagnosis

  https://smw.ch/index.php/smw/article/download/2356/3595?inline=1

  Acute aortic dissection is a rare but life-threatening condition with a lethality rate of 1 to 2% per hour after onset of symptoms in untreated patients. […] Advanced age, male gender, long-term history of arterial hypertension and the presence of aortic aneurysm confer the greatest population attributable risk. […] However, patients with genetic connective tissue disorders such as Marfan, Loeys Dietz or Ehlers Danlos syndrome, and patients with bicuspid aortic valves are at the increased risk of aortic dissection at a much younger age. […] Aortic dissection arises from a tear in the aortic intima exposing the medial layer to the pulsatile blood flow. […] At the molecular level, aortic dissection is the result of remodelling of the aortic wall structure as a result of inflammation and extracellular matrix degradation.

• #80 Acute aortic dissection (AAD) – a lethal disease: the epidemiology, pathophysiology and natural history

  https://bjcardio.co.uk/2023/03/acute-aortic-dissection-aad-a-lethal-disease-the-epidemiology-pathophysiology-and-natural-history/

  Aortic dissection is a life-threatening condition that is often under-recognised. […] Aortic dissection was described historically as far back as the time of King George II, and is now understood better in modern times. […] A tear on the innermost lining of the vessel, which creates false channels, enlargement of the size of the vessel and rupture, as well as lack of blood to some of the most vital organs inside the body, it gets little press compared with other diseases such as cancer and heart disease. […] From this we can ascertain that dissection is generally a disease of older age, mostly caused by hypertension, and is more common in men. […] Long history of uncontrolled or undiagnosed hypertension and the presence of aortic aneurysm represent the main risk factors associated with AAD, followed by bicuspid aortic valve and genetic connective tissue disorders.

• #81 Risk Factors for Aortic Dissection | USC Journal

  https://www.uscjournal.com/articles/risk-factors-aortic-dissection?language_content_entity=en

  There is a risk of AD developing during or immediately following pregnancy. […] Sildenafil became the first oral pill for erectile dysfunction in the US. […] However, some cases of AD have been associated with sildenafil, because it is a vasodilator and can decrease aortic stiffness. […] Cocaine is listed among both predisposing and aggravating factors for AD. […] Iatrogenic AD (IAD) is the presence of AD as a complication of a cardiac procedure. […] Understanding the risk factors for AD may contribute to the slowing down of progression, limiting complications of the disease, and improving patient prognosis.

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