Aortic Dissection

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Causes and Risk Factors

The exact cause for aortic dissection is unknown; however, risk factors associated with the condition have been identified. High blood pressure (hypertension) is the leading risk factor. Hypertension, which is present in 2/3 of all cases, puts pressure on the aortic wall, weakening it and making it more likely to tear.

Other risk factors include the following:

• Aortic aneurysm (enlarged blood vessel)
• Aortic valve problems (e.g., aortic stenosis)
• Cocaine use
• Connective tissue disorders (e.g., scleroderma)
• Family history of aortic dissection
• Hardening of the arteries (atherosclerosis)
• Narrowing or enlargement of the aorta
• Syphilis (sexually transmitted disease [STD] caused by bacteria)

Genetic (hereditary) connective tissue disorders can increase the risk for aortic dissection. Patients who have Marfan syndrome or Ehlers-Danlos syndrome (conditions that weaken connective tissue) are at increased risk for blood vessel rupture. Turner syndrome, which occurs in patients who have 45 chromosomes instead of the normal 46, can lead to heart problems and high blood pressure, increasing risk for aortic dissection.

In rare cases, patients experience aortic dissection as a result of open heart surgery or heart catheterization (i.e., cardiac catheterization). The risk for aortic dissection is slightly higher than normal in women who are pregnant.

Blunt trauma to the chest (in a car accident, for example) is another potential cause for aortic dissection.

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