Thoracic aortic aneurysm causes: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{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== | ||
=== | ===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]] | ||
*[[ | *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]] | ||
*[[ | *[[Temporal arteritis]] | ||
*[[ | * Traumatic - Sudden deceleration | ||
*[[Turner's syndrome]] | |||
*[[Wegener's granulomatosis]] | |||
==Causes Based Upon Inherited versus Sporadic versus Syndromic Basis== | |||
===Sporadic Causes=== | |||
*[[Ankylosing spondylitis]] | *[[Ankylosing spondylitis]] | ||
* | *[[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>. | ||
*[[Loeys-Dietz syndrome]] | *[[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> | ||
*[[Ehlers-Danlos syndrome]] | *[[Ehlers-Danlos syndrome]] | ||
*[[Turner's syndrome]] | *[[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> | ||
==References== | ==References== | ||
{{ | {{Reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[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
Thoracic aortic aneurysm Microchapters |
Differentiating Thoracic Aortic Aneurysm from other Diseases |
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Thoracic aortic aneurysm causes On the Web |
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Risk calculators and risk factors for Thoracic aortic aneurysm causes |
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.