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2264 pages added, reviewed or updated during the last month (last updated: 21/4/2021)


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aetiology and risk factors

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Aetiolgy of aortic dissection is multifactorial. Both acquired degenerative disease and inherited susceptibility are thought to be responsible.

Important risk factors for aortic dissection include:

  • systemic hypertension
    • is the most important risk factor and seen in 40-75% of patients as the presenting condition
  • connective tissue disorders - inherent weakness of the aortic wall leads to subsequent dissection and is especially important in patients under the age of 40 years
    • Marfan’s syndrome
      • develops in 20-40% of patients with Marfan's syndrome
      • this condition often underlies dissection in teenagers
    • Ehlers-Danlos syndrome
    • Turners syndrome
  • congenital cardiovascular abnormalities
    • bicuspid aortic valves
      • a cross sectional study has revealed that there is fivefold to 18fold increased risk of dissection in patients with bicuspid aortic valves
    • coarctation
      • because of its association with hypertension and congenital disorders of the aortic valve
  • pregnancy - 50% of dissections in the under 40's are in pregnant women. Most at risk are primiparous women in the last trimester of pregnancy
  • cocaine misuse
  • iatrogenic
    • surgery to the aorta - following aortic cannulation for cardiopulmonary bypass or aortic valve replacement - but uncommon
  • dceleration trauma e.g. – accident, fall from a height
  • aortic vasculitic disease

Reference:

Last reviewed 01/2018

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