From the Guidelines
Disorders that significantly increase the risk of aortic dissection include genetic connective tissue disorders such as Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome, as well as Turner syndrome, bicuspid aortic valve, and familial thoracic aortic aneurysm syndromes. These conditions can affect the structural integrity of blood vessel walls, leading to a higher risk of aortic complications 1. Hypertension is also a major risk factor, causing chronic stress on the aortic wall that can lead to weakening over time 1. Inflammatory conditions like giant cell arteritis and Takayasu arteritis can damage the aortic wall, and pre-existing aortic aneurysms significantly increase the risk of dissection 1.
Some key points to consider include:
- Genetic connective tissue disorders: Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome are all associated with an increased risk of aortic dissection 1
- Turner syndrome: This genetic condition affects females and is associated with cardiovascular abnormalities, including aortic dissection 1
- Bicuspid aortic valve: This congenital heart condition can predispose individuals to aortic complications 1
- Familial thoracic aortic aneurysm syndromes: These syndromes can increase the risk of aortic dissection, particularly in individuals with a family history of the condition 1
- Hypertension: Uncontrolled hypertension can cause chronic stress on the aortic wall, leading to weakening over time 1
- Inflammatory conditions: Giant cell arteritis and Takayasu arteritis can damage the aortic wall, increasing the risk of dissection 1
- Pre-existing aortic aneurysms: These can significantly increase the risk of aortic dissection, particularly if left untreated 1
Understanding these risk factors is crucial for early identification of high-risk patients who may benefit from preventive measures, including blood pressure control, beta-blocker therapy, and in some cases, prophylactic surgical intervention 1.
From the Research
Disorders that Increase the Risk of Aortic Dissection
The following disorders are known to increase the risk of aortic dissection:
- Marfan syndrome: a genetic connective tissue disorder that causes aortic dilation leading to dissection and death 2, 3, 4, 5, 6
- Loeys-Dietz syndrome: a genetic connective tissue disorder that increases the risk of aortic dissection at a young age 3
- Ehlers-Danlos syndrome: a genetic connective tissue disorder that increases the risk of aortic dissection at a young age 3
- Bicuspid aortic valve: a congenital heart defect that increases the risk of aortic dissection 3
Key Factors that Contribute to the Risk of Aortic Dissection
Some key factors that contribute to the risk of aortic dissection in these disorders include:
- Aortic dilation: an increase in the diameter of the aorta, which can lead to dissection 2, 5
- Prior prophylactic aortic surgery: patients who have undergone prior prophylactic aortic surgery are at substantial risk for type B aortic dissection 5
- Proximal descending aorta diameter ≥27 mm: an increased diameter of the proximal descending aorta is associated with an increased risk of type B aortic dissection 5
- Advanced age: increased age is a risk factor for aortic dissection 3
- Male gender: males are at a higher risk of aortic dissection than females 3
- Long-term history of arterial hypertension: hypertension is a risk factor for aortic dissection 3
- Presence of aortic aneurysm: an aortic aneurysm increases the risk of aortic dissection 3