Thoracic aortic aneurysm causes: Difference between revisions

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{{Thoracic aortic aneurysm}}
{{Thoracic aortic aneurysm}}
{{CMG}}; {{AE}} {{AN}}
{{CMG}}; {{AE}} {{AN}} [[User:Mohammed Salih|Mohammed Salih, MD.]] [mailto:Mohammed.Salih@stjoeshealth.org]
 


==Overview==
==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==
==Causes==
===Sporadic Causes===
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
 
*[[Aortic dissection]]
 
===Common Causes===
*[[Aortic dissection]]<ref name="pmid28159818">{{cite journal |vauthors=Cheung K, Boodhwani M, Chan KL, Beauchesne L, Dick A, Coutinho T |title=Thoracic Aortic Aneurysm Growth: Role of Sex and Aneurysm Etiology |journal=J Am Heart Assoc |volume=6 |issue=2 |pages= |date=February 2017 |pmid=28159818 |pmc=5523737 |doi=10.1161/JAHA.116.003792 |url=}}</ref>
*[[Atherosclerosis]]
*[[Marfan's syndrome]]
 
===Causes by Organ System===
{|style="width:70%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |[[Aortic dissection]], [[aortic stenosis]], [[aortic valve replacement]], [[aortitis]], [[atherosclerosis]], [[bacterial endocarditis]], [[bicuspid aortic valve]], [[systemic hypertension]]
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Arterial tortuosity syndrome]], [[bicuspid aortic valve]], [[Ehlers-Danlos syndrome]], [[familial thoracic aortic aneurysms and dissections]], [[Loeys-Dietz syndrome]], [[Marfan syndrome]], [[Turner syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| Previous surgery on the [[aorta]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Aortitis]], [[quaternary syphilis]], [[septic embolism]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Wegener's granulomatosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[aortitis]], [[Behcet's disease]], [[giant cell arteritis]], [[reactive arthritis]], [[rheumatoid arthritis]], [[rheumatoid vasculitis]], [[Takayasu's arteritis]], [[Wegener's granulomatosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Chest trauma|Sudden deceleration]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}
 
===Causes in Alphabetical Order===
*[[Ankylosing spondylitis]]
*[[Aortic dissection]]
*[[Aortic stenosis]]
*[[Aortitis]]
*[[Aortic valve replacement]]
*[[Arterial tortuosity syndrome]]
*[[Atherosclerosis]]
*[[Atherosclerosis]]
*[[Syphilis]]
*Bacterial infection, often following valvular [[endocarditis]]
:#[[Salmonella]]
:#[[Staphylococcus aureus]]
:#[[Staphylococcus epidermidis]]
:#[[Streptococcus]]
:#[[Tuberculosis]]
*[[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]]
*[[Takayasu's arteritis]]
*[[Giant cell arteritis]]
*[[Temporal arteritis]]
*[[Behcet's disease]]
* Traumatic - Sudden deceleration
*[[Turner's syndrome]]
*[[Wegener's granulomatosis]]
 
==Causes Based Upon Inherited versus Sporadic versus Syndromic Basis==
===Sporadic Causes===
*[[Ankylosing spondylitis]]
*[[Ankylosing spondylitis]]
*Traumatic - Sudden deceleration
*[[Atherosclerosis]]
*Bacterial infection, often following valvular [[endocarditis]]
:#[[Staphylococcus aureus]]<ref name="pmid28878584">{{cite journal |vauthors=Naidu DP, Quinones JA, Lutschg KW, Balaguru D |title=Healthy Adolescent with a Mycotic Aortic Aneurysm from Community-Acquired Methicillin-Resistant Staphylococcus aureus |journal=Tex Heart Inst J |volume=44 |issue=4 |pages=279–282 |date=August 2017 |pmid=28878584 |pmc=5577956 |doi=10.14503/THIJ-16-5932 |url=}}</ref>
:#[[Staphylococcus epidermidis]]
:#[[Salmonella]]
:#[[Streptococcus]]
:#[[Tuberculosis]]<ref name="pmid27499987">{{cite journal |vauthors=Im KS, Choi MK, Jeon YK, Lee JM |title=Dissecting thoracic aortic aneurysm associated with tuberculous pleural effusion |journal=J Thorac Dis |volume=8 |issue=7 |pages=E520–2 |date=July 2016 |pmid=27499987 |pmc=4958844 |doi=10.21037/jtd.2016.05.68 |url=}}</ref>
*[[Behcet's disease]]<ref name="pmid28874203">{{cite journal |vauthors=Zhang SH, Zhang FX |title=Behcet's disease with recurrent thoracic aortic aneurysm combined with femoral artery aneurysm: a case report and literature review |journal=J Cardiothorac Surg |volume=12 |issue=1 |pages=79 |date=September 2017 |pmid=28874203 |pmc=5585960 |doi=10.1186/s13019-017-0644-y |url=}}</ref>
*[[Giant cell arteritis]]<ref name="pmid23253927">{{cite journal |vauthors=Kermani TA, Warrington KJ, Crowson CS, Ytterberg SR, Hunder GG, Gabriel SE, Matteson EL |title=Large-vessel involvement in giant cell arteritis: a population-based cohort study of the incidence-trends and prognosis |journal=Ann. Rheum. Dis. |volume=72 |issue=12 |pages=1989–94 |date=December 2013 |pmid=23253927 |pmc=4112513 |doi=10.1136/annrheumdis-2012-202408 |url=}}</ref>
*Previous injury to the aorta such as an [[aortic dissection]]
*Previous injury to the aorta such as an [[aortic dissection]]
*[[Syphilis]]<ref name="pmid27777861">{{cite journal |vauthors=Li W, Yin XJ, Liu HY, Yang R |title=Syphilitic aortic aneurysm with a pulmonary lesion: a case report and literature view |journal=Springerplus |volume=5 |issue=1 |pages=1725 |date=2016 |pmid=27777861 |pmc=5053956 |doi=10.1186/s40064-016-3397-5 |url=}}</ref>
*[[Takayasu's arteritis]]<ref name="pmid31575993">{{cite journal |vauthors=Pan L, Du J, Chen D, Zhao Y, Guo X, Qi G, Wang T, Du J |title=Takayasu Arteritis with Dyslipidemia Increases Risk of Aneurysm |journal=Sci Rep |volume=9 |issue=1 |pages=14083 |date=October 2019 |pmid=31575993 |pmc=6773689 |doi=10.1038/s41598-019-50527-z |url=}}</ref>
*Traumatic - sudden deceleration


===Familial Causes===
===Familial Causes===
*[[Familial thoracic aortic aneurysms and dissections]]
*[[Familial thoracic aortic aneurysms and dissections]]<ref name="pmid27297344">{{cite journal |vauthors=Isselbacher EM, Lino Cardenas CL, Lindsay ME |title=Hereditary Influence in Thoracic Aortic Aneurysm and Dissection |journal=Circulation |volume=133 |issue=24 |pages=2516–28 |date=June 2016 |pmid=27297344 |pmc=5031368 |doi=10.1161/CIRCULATIONAHA.116.009762 |url=}}</ref>
*[[Bicuspid aortic valve]]
*[[Bicuspid aortic valve]] with post-stenotic dilation due to turbulence<ref name="pmid28659818">{{cite journal |vauthors=Norton E, Yang B |title=Managing Thoracic Aortic Aneurysm in Patients with Bicuspid Aortic Valve Based on Aortic Root-Involvement |journal=Front Physiol |volume=8 |issue= |pages=397 |date=2017 |pmid=28659818 |pmc=5469203 |doi=10.3389/fphys.2017.00397 |url=}}</ref>


===Syndromic Causes===
===Syndromic Causes===
*[[Marfan's syndrome]]
*[[Marfan's syndrome]]: Aortic root dilation with or without associated [[aortic regurgitation]] occurs in 75%-80% of marfan's patients<ref name="pmid27274304">{{cite journal |vauthors=Pepe G, Giusti B, Sticchi E, Abbate R, Gensini GF, Nistri S |title=Marfan syndrome: current perspectives |journal=Appl Clin Genet |volume=9 |issue= |pages=55–65 |date=2016 |pmid=27274304 |pmc=4869846 |doi=10.2147/TACG.S96233 |url=}}</ref>.
**Genetic condition*Affects connective tissue
*[[Loeys-Dietz syndrome]]<ref name="pmid30614814">{{cite journal |vauthors=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 |title=Lineage-specific events underlie aortic root aneurysm pathogenesis in Loeys-Dietz syndrome |journal=J. Clin. Invest. |volume=129 |issue=2 |pages=659–675 |date=February 2019 |pmid=30614814 |pmc=6355234 |doi=10.1172/JCI123547 |url=}}</ref>
**Weakness in aortic wall increases susceptibility of an aneurysm
**Distinct physical traits- tall stature, very long arms, eye problems, and a deformed breastbone
*[[Loeys-Dietz syndrome]]
*[[Ehlers-Danlos syndrome]]
*[[Ehlers-Danlos syndrome]]
**Causes skin and joints to be fragile and makes your skin stretch easily
*[[Turner's syndrome]]<ref name="pmid30281655">{{cite journal |vauthors=Corbitt H, Morris SA, Gravholt CH, Mortensen KH, Tippner-Hedges R, Silberbach M, Maslen CL |title=TIMP3 and TIMP1 are risk genes for bicuspid aortic valve and aortopathy in Turner syndrome |journal=PLoS Genet. |volume=14 |issue=10 |pages=e1007692 |date=October 2018 |pmid=30281655 |pmc=6188895 |doi=10.1371/journal.pgen.1007692 |url=}}</ref>
*[[Turner's syndrome]]


==References==
==References==
{{reflist|2}}
{{Reflist|2}}


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[[Category:Disease]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Vascular surgery]]
[[Category:Vascular surgery]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Crowdiagnosis]]

Latest revision as of 17:26, 23 June 2020

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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

  1. Salmonella
  2. Staphylococcus aureus
  3. Staphylococcus epidermidis
  4. Streptococcus
  5. Tuberculosis

Causes Based Upon Inherited versus Sporadic versus Syndromic Basis

Sporadic Causes

  1. Staphylococcus aureus[2]
  2. Staphylococcus epidermidis
  3. Salmonella
  4. Streptococcus
  5. Tuberculosis[3]

Familial Causes

Syndromic Causes

References

  1. ↑ 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.
  2. ↑ 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.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ 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.
  6. ↑ 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.
  7. ↑ 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.
  8. ↑ 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.
  9. ↑ 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.
  10. ↑ 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.
  11. ↑ 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.
  12. ↑ 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.

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