Thoracic aortic aneurysm causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2] Mohammed Salih, MD. [3]
Overview
Two of the most common causes of thoracic aorta aneurysm are Marfan's syndrome and atherosclerosis. In some centers, a prior history of dissection with aneurysmal dilation is the most common cause of surgical repair.
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Causes by Organ System
| Cardiovascular | Aortic dissection, aortic stenosis, aortic valve replacement, aortitis, atherosclerosis, bacterial endocarditis, bicuspid aortic valve, systemic hypertension |
| Chemical / poisoning | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | No underlying causes |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | Arterial tortuosity syndrome, bicuspid aortic valve, Ehlers-Danlos syndrome, familial thoracic aortic aneurysms and dissections, Loeys-Dietz syndrome, Marfan syndrome, Turner syndrome |
| Hematologic | No underlying causes |
| Iatrogenic | Previous surgery on the aorta |
| Infectious Disease | Aortitis, quaternary syphilis, septic embolism |
| Musculoskeletal / Ortho | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional / Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | Wegener's granulomatosis |
| Renal / Electrolyte | No underlying causes |
| Rheum / Immune / Allergy | Ankylosing spondylitis, aortitis, Behcet's disease, giant cell arteritis, reactive arthritis, rheumatoid arthritis, rheumatoid vasculitis, Takayasu's arteritis, Wegener's granulomatosis |
| Sexual | No underlying causes |
| Trauma | Sudden deceleration |
| Urologic | No underlying causes |
| Miscellaneous | No underlying causes |
Causes in Alphabetical Order
- Ankylosing spondylitis
- Aortic dissection
- Aortic stenosis
- Aortitis
- Aortic valve replacement
- Arterial tortuosity syndrome
- Atherosclerosis
- Bacterial infection, often following valvular endocarditis
- Behcet's disease
- Bicuspid aortic valve
- Ehlers-Danlos syndrome
- Familial thoracic aortic aneurysms and dissections
- Giant cell arteritis
- Loeys-Dietz syndrome
- Marfan's syndrome
- Quaternary syphilis
- Reactive arthritis
- Rheumatoid arthritis
- Rheumatoid vasculitis
- Septic embolism
- Systemic hypertension
- Takayasu's arteritis
- Temporal arteritis
- Traumatic - Sudden deceleration
- Turner's syndrome
- Wegener's granulomatosis
Causes Based Upon Inherited versus Sporadic versus Syndromic Basis
Sporadic Causes
- Ankylosing spondylitis
- Atherosclerosis
- Bacterial infection, often following valvular endocarditis
- Behcet's disease[4]
- Giant cell arteritis[5]
- Previous injury to the aorta such as an aortic dissection
- Syphilis[6]
- Takayasu's arteritis[7]
- Traumatic - sudden deceleration
Familial Causes
- Familial thoracic aortic aneurysms and dissections[8]
- Bicuspid aortic valve with post-stenotic dilation due to turbulence[9]
Syndromic Causes
- Marfan's syndrome: Aortic root dilation with or without associated aortic regurgitation occurs in 75%-80% of marfan's patients[10].
- Loeys-Dietz syndrome[11]
- Ehlers-Danlos syndrome
- Turner's syndrome[12]
References
- ↑ Cheung K, Boodhwani M, Chan KL, Beauchesne L, Dick A, Coutinho T (February 2017). "Thoracic Aortic Aneurysm Growth: Role of Sex and Aneurysm Etiology". J Am Heart Assoc. 6 (2). doi:10.1161/JAHA.116.003792. PMC 5523737. PMID 28159818.
- ↑ Naidu DP, Quinones JA, Lutschg KW, Balaguru D (August 2017). "Healthy Adolescent with a Mycotic Aortic Aneurysm from Community-Acquired Methicillin-Resistant Staphylococcus aureus". Tex Heart Inst J. 44 (4): 279–282. doi:10.14503/THIJ-16-5932. PMC 5577956. PMID 28878584.
- ↑ Im KS, Choi MK, Jeon YK, Lee JM (July 2016). "Dissecting thoracic aortic aneurysm associated with tuberculous pleural effusion". J Thorac Dis. 8 (7): E520–2. doi:10.21037/jtd.2016.05.68. PMC 4958844. PMID 27499987.
- ↑ Zhang SH, Zhang FX (September 2017). "Behcet's disease with recurrent thoracic aortic aneurysm combined with femoral artery aneurysm: a case report and literature review". J Cardiothorac Surg. 12 (1): 79. doi:10.1186/s13019-017-0644-y. PMC 5585960. PMID 28874203.
- ↑ Kermani TA, Warrington KJ, Crowson CS, Ytterberg SR, Hunder GG, Gabriel SE, Matteson EL (December 2013). "Large-vessel involvement in giant cell arteritis: a population-based cohort study of the incidence-trends and prognosis". Ann. Rheum. Dis. 72 (12): 1989–94. doi:10.1136/annrheumdis-2012-202408. PMC 4112513. PMID 23253927.
- ↑ Li W, Yin XJ, Liu HY, Yang R (2016). "Syphilitic aortic aneurysm with a pulmonary lesion: a case report and literature view". Springerplus. 5 (1): 1725. doi:10.1186/s40064-016-3397-5. PMC 5053956. PMID 27777861.
- ↑ Pan L, Du J, Chen D, Zhao Y, Guo X, Qi G, Wang T, Du J (October 2019). "Takayasu Arteritis with Dyslipidemia Increases Risk of Aneurysm". Sci Rep. 9 (1): 14083. doi:10.1038/s41598-019-50527-z. PMC 6773689 Check
|pmc=value (help). PMID 31575993. - ↑ Isselbacher EM, Lino Cardenas CL, Lindsay ME (June 2016). "Hereditary Influence in Thoracic Aortic Aneurysm and Dissection". Circulation. 133 (24): 2516–28. doi:10.1161/CIRCULATIONAHA.116.009762. PMC 5031368. PMID 27297344.
- ↑ Norton E, Yang B (2017). "Managing Thoracic Aortic Aneurysm in Patients with Bicuspid Aortic Valve Based on Aortic Root-Involvement". Front Physiol. 8: 397. doi:10.3389/fphys.2017.00397. PMC 5469203. PMID 28659818.
- ↑ Pepe G, Giusti B, Sticchi E, Abbate R, Gensini GF, Nistri S (2016). "Marfan syndrome: current perspectives". Appl Clin Genet. 9: 55–65. doi:10.2147/TACG.S96233. PMC 4869846. PMID 27274304.
- ↑ MacFarlane EG, Parker SJ, Shin JY, Kang BE, Ziegler SG, Creamer TJ, Bagirzadeh R, Bedja D, Chen Y, Calderon JF, Weissler K, Frischmeyer-Guerrerio PA, Lindsay ME, Habashi JP, Dietz HC (February 2019). "Lineage-specific events underlie aortic root aneurysm pathogenesis in Loeys-Dietz syndrome". J. Clin. Invest. 129 (2): 659–675. doi:10.1172/JCI123547. PMC 6355234. PMID 30614814.
- ↑ Corbitt H, Morris SA, Gravholt CH, Mortensen KH, Tippner-Hedges R, Silberbach M, Maslen CL (October 2018). "TIMP3 and TIMP1 are risk genes for bicuspid aortic valve and aortopathy in Turner syndrome". PLoS Genet. 14 (10): e1007692. doi:10.1371/journal.pgen.1007692. PMC 6188895. PMID 30281655.