Aortic Dissection Overview

Aortic Dissection Causes

• Hypertension: Major cause, responsible for 70% of cases.
• Atherosclerosis: Contributes to 10-15% of cases through increased diffusion distance.

Connective Tissue Disorders

• Marfan Syndrome, Loeys-Dietz Syndrome, Ehlers-Danlos Syndrome: Lead to increased risk due to weakened media.

Histological Findings

• Cystic Medial Regeneration: Characterized by hyper sulfated glycosaminoglycans and diminished elastic tissue synthesis.

Inflammatory Causes

• Vasculitis: Conditions like giant cell arteritis can weaken the media, leading to dissection.
• Takayasu's Arteritis: Affects great vessels from the aortic arch, also a potential cause.

Anatomic Abnormalities

• Bicuspid Aortic Valve: Associated with calcification, myxomatous degeneration, increased aortic root dilation risk.
• Coarctation of the Aorta: Increases local turbulence and abnormal muscle cell biology, contributing to dissections.

Aortic Dissection Incidents

• Trauma: Sudden deceleration (e.g., automobile accidents) can tear the aorta at the ligamentum arteriosum.
• Surgical Procedures: Cardiac surgery, cardiac catheterization can weaken the aortic wall.
• Drugs: Certain stimulants like amphetamines and cocaine may induce blood pressure spikes, leading to dissections.

Typical Dissection Locations

• Most dissections occur within the first 10 cm above the aortic valve.
• Trauma-related dissections typically occur at the ligamentum arteriosum.