Acute Aortic Syndromes

Tsai, Thomas T.; Nienaber, Christoph; Eagle, Kim A.

doi:10.1161/circulationaha.105.534198

Cited by 512 publications

(417 citation statements)

References 108 publications

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“…A ortic dissection and intramural haematoma comprise a potentially life-threatening aortopathy involving separation of the aortic wall [1][2][3][4][5][6] . The two conditions are distinguished by a tear in the aortic intima as present in the former classical form of aortic dissection, which results in blood flow into the aortic wall and is absent in the latter form of intramural haematoma with bleeding confined within the aortic wall.…”

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confidence: 99%

Granulocyte macrophage colony-stimulating factor is required for aortic dissection/intramural haematoma

et al. 2015

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Aortic dissection and intramural haematoma comprise an aortopathy involving separation of the aortic wall. Underlying mechanisms of the condition remain unclear. Here we show that granulocyte macrophage colony-stimulating factor (GM-CSF) is a triggering molecule for this condition. Transcription factor Krüppel-like factor 6 (KLF6)-myeloid-specific conditional deficient mice exhibit this aortic phenotype when subjected to aortic inflammation. Mechanistically, KLF6 downregulates expression and secretion of GM-CSF. Administration of neutralizing antibody against GM-CSF prevents the condition in these mice. Conversely, administration of GM-CSF in combination with aortic inflammation to wild-type mice is sufficient to induce the phenotype, suggesting the general nature of effects. Moreover, patients with this condition show highly increased circulating levels of GM-CSF, which is also locally expressed in the dissected aorta. GM-CSF is therefore a key regulatory molecule causative of this aortopathy, and modulation of this cytokine might be an exploitable treatment strategy for the condition.

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confidence: 99%

Granulocyte macrophage colony-stimulating factor is required for aortic dissection/intramural haematoma

et al. 2015

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“…The risk factors for aortic dissection include longstanding hypertension, connective tissue disorders, vascular malformations, vascular inflammation, trauma, and iatrogenic related to cardiac or aortic surgery and instrumentation [1,6]. In the consideration of associations with the development of aortic dissection, hypertension is the most common risk factor.…”

Section: Discussionmentioning

confidence: 99%

“…With respect to sensitivity and specificity for acute aortic pathology, contrast-enhanced spiral CT scanning, Transthoracic or Transesophageal Echocardiography (TTE or TEE), and MRI all have comparable accuracy of near 100% [1,14]. The selection of test depends upon a number of factors such as availability, urgency, confirmation of the tear, localization, extent, classification and determination of emergent intervention [1]. In acute phase, CT is the most used imaging technique owing to its wider availability and accuracy [3,15].…”

Section: Discussionmentioning

confidence: 99%

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An extensive chronic aortic dissection presenting with acute embolic stroke

Basnet

Mainali

Tharu

et al. 2017

Journal of Community Hospital Internal Medicine Perspectives

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Herein, we present a rare case of extensive chronic aortic dissection with extension to bilateral subclavian arteries, bilateral common carotid arteries, right internal carotid artery, bilateral proximal external iliac arteries and simultaneous presentation of acute embolic stroke and seizure. The rarity of this case presentation and the presence of neurological features necessitated a high index of clinical suspicion to reach the definitive diagnosis. This study also demonstrates a unique situation requiring correlation between chronic aortic dissection and multi-organ system dysfunction from chronic ischemia.

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“…12 A delay in diagnosis has been noted in patients presenting with ischemic changes on ECG. 13 Acute coronary syndrome-like ECG findings occur in 26 % of Type A aortic dissections.…”

Section: Discussionmentioning

confidence: 99%

NSTEMI or Not: A 59-Year-Old Man with Chest Pain and Troponin Elevation

et al. 2012

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A 59-year-old African-American man with a history of hypertension, hyperlipidemia, and cerebrovascular disease presented to the emergency department complaining of chest pain. He stated that the pain began suddenly while he was seated at home several hours prior to presentation. He described the pain as throbbing, 9 out of 10 in intensity, substernal, and associated with nausea, diaphoresis, and dyspnea. He stated that the pain radiated to his left leg but not to his arm or jaw. The pain resolved spontaneously after an hour, but then recurred 3 hours later. He had never experienced pain like this before. He initially delayed coming to the hospital, expecting the chest pain to subside spontaneously again; but finally his family brought him in when he became disoriented and confused.

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Acute Aortic Syndromes

Cited by 512 publications

References 108 publications

Granulocyte macrophage colony-stimulating factor is required for aortic dissection/intramural haematoma

Granulocyte macrophage colony-stimulating factor is required for aortic dissection/intramural haematoma

An extensive chronic aortic dissection presenting with acute embolic stroke

NSTEMI or Not: A 59-Year-Old Man with Chest Pain and Troponin Elevation

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