Etiologic Factors of Acute Aortic Dissection in Children and Younrg Adults

Fikar, Charles R.; Koch, Simone

doi:10.1177/000992280003900201

Cited by 65 publications

(73 citation statements)

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“…15 Conditions that weaken the aortic medial layer predispose to aortic dissection. 11,15,16 Some reports have indicated that congenital cardiovascular anomalies are the most common predisposing conditions for acute aortic dissection occurring in the pediatric population. 5 Traumatic aortic dissections are usually stated to be very rare.…”

Section: Introductionmentioning

confidence: 99%

Aortic Dissection in Childhood and Adolescence: An Analysis of Occurrences Over a 10‐Year Interval in New York State

Fikar

2009

Clinical Cardiology

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BackgroundRarely occurring in the pediatric and adolescent population, aortic dissection is a condition with many predisposing factors. Previous studies have suggested that congenital cardiovascular disorders are the most common predisposing conditions. Trauma‐associated aortic dissection is considered a rare occurrence.MethodsThe Statewide Planning and Research Cooperative System database of New York State was used to retrieve cases of aortic dissection in persons ≤ 21 years old over a 10‐year period. A retrospective analysis for risk or associated conditions was undertaken.ResultsForty‐five of a total of 12 142 cases of aortic dissection (0.37%) occurred in persons ≤ 21 years old. No patient was younger than 15 years of age. Six of the 45 died (13%). Most patients were male (37 of 45, or 82%). Contrary to previous reports, the most common associated condition was trauma (19 of 45, or 42%), with Marfan syndrome the second most common (11 of 45, or 24%). Ten of 45 adolescent and young adult patients (22%) had no apparent risk factors.ConclusionsTraumatic aortic disruptions must be considered in children and adolescents who survive serious chest trauma. Family members of pediatric and young adult patients with trauma‐associated aortic dissection may need to be evaluated for possible risk of aortic dissection. Copyright © 2009 Wiley Periodicals, Inc.

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Section: Introductionmentioning

confidence: 99%

Aortic Dissection in Childhood and Adolescence: An Analysis of Occurrences Over a 10‐Year Interval in New York State

Fikar

2009

Clinical Cardiology

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“…Aort diseksiyonu için risk faktörleri genel olarak hipertansiyon, arterioskleroz, Marfan sendromu ve Tip IV Ehlers Danlos sendromu gibi herediter bağ dokusu hastalıkları, fibromuskuler displazi, aortun intrensek anomalileri, aort kapak anomalileri, gebelik, aortun inflamatuar hastalıkları, ağır fiziksel egzersiz ve ağırlık kaldırma, travma, aorta yapılan cerrahi ve tıbbi girişimler ve kokain kullanımı olduğu bildirilmektedir (5). Bizim olgumuzda bilinen herhangi bir hastalığın olmadığı belirtilmiştir.…”

Section: Discussionunclassified

“…Ani göğüs ve/veya bel ağrısı ile karakterize olan aort diseksiyonu, yaşamı tehdit etmektedir (4). Etiyolojisinde hipertansiyon, ateroskleroz, Marfan ve Ehler Danlos gibi hastalıklar yer almaktadır (5,6). Amerika Birleşik Devletleri'nde insidansı yılda milyonda 5-30 olgu arasında değişmektedir (7).…”

Section: Introductionunclassified

Dissekan Aort Anevrizması Rüptürüne Bağlı Ani Ölüm Olgusu

İlhan¹,

Beyaztaş²,

Bütün³

et al. 2014

Bull Leg Med

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ÖZETAort diseksiyonu aortanın en sık rastlanan ölümcül hastalığı olup, acil tanı ve tedavi gerektirmektedir. Ani başlayan ve yırtıcı vasıftaki göğüs ağrısı ile karakterize olan aort diseksiyonu tanısında en önemli basamak klinik şüphedir. Özellikle atipik yakınmalarla başvuran olgularda tanı koymak oldukça güçtür. Hastalığın mortalitesi, tedavi edilmediği takdirde her saat % 1-2 oranında artmaktadır. Bu çalışmada; bulantı ve kusma gibi atipik yakınmalarla acile başvuran, elli iki yaşında bir kadın olgu sunumu yapılmıştır. Olgu sadece bulantı ve kusma şikayetleri ile acil servise başvurmuş, yapılan muayene ve tetkik sonucunda kardiyak patoloji bulunmadığı belirtilmiştir. Altı saat sonra genel durumu bozulmuş ve ölmüştür. Yapılan otopside; perikart ön yüzde iki adet rüptüre alan olduğu, çıkan aortada tespit edilen rüptüre alandan aort köküne doğru 8.5 cm uzunluğunda diseksiyon olduğu, ölüm nedeninin disekan aort anevrizma rüptürü olduğu saptanmıştır. Aort diseksiyonu tanısındaki gecikmeler ölüme yol açabileceği gibi hekimleri de önemli adli sorunlarla karşı karşıya bırakabilecektir. Ayrıca tanının erken konulması ile beklenmedik bir anda şüpheli olarak ölen olguların adli olgu kapsamında değerlendirilerek gereksizce adli işlem yapılmasının da önüne geçilebilecektir.Anahtar kelimeler: Aort rüptürü, ani ölüm, aort anevrizması, otopsi, adli tıp. ABSTRACTAortic dissection of the aorta is the most common fatal disease requires urgent diagnosis and treatment. The most important step in the diagnosis of aortic dissection which is characterized by sudden onset of chest pain in predatory manner is the clinical suspicion. Especially in patients who present with atypical symptoms is difficult to diagnose. The mortality rate is increasing by 1-2% every hour if left untreated. In this study we presented a fifty-two-year-old female case with atypic symptoms, such as nausea and vomiting, admitted to the emergency room. The patient admitted to the emergency department with only nausea and vomiting complaints and at the end of the examination it was decided that there were no cardiac pathology. Six hours later, the overall situation has deteriorated, and the patient died. In the autopsy we revealed two pericardial rupture in the front pericardial area, also there was 8.5 cm long identified ruptured aortic dissection beginning from the ascending aorta to the root of aorta, which was the cause of death. Delays in diagnosis of aortic dissection can lead to death, also the physicians can face with important legal issues. Early diagnosis of patients, who died suddenly and unexpected, can avoid unnecessary judicial proceedings.

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“…Although progressive dilatation of the ascending aorta has been described in pediatric patients with bicuspid aortic valve (BAV), the occurrence of aortic dissection is rare (1)(2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%