Acute Aortic Dissection and Intramural Hematoma

Mussa, Firas F.; Horton, Joshua D.; Moridzadeh, Rameen S.; Nicholson, Joey; Trimarchi, Santi; Eagle, Kim A.

doi:10.1001/jama.2016.10026

Cited by 415 publications

(337 citation statements)

References 69 publications

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“…For the purposes of the review, we included studies that phenotyped participants using the following imaging tests: transthoracic echocardiogram (TTE)/transoesophageal echocardiogram, computed tomography (CT), or magnetic resonance imaging (MRI) of the thoracic aorta, and genetic screening, individually or in combination with the acknowledgement that sensitivities and specificities of CT (100% and 100%, respectively) and MRI (95–100%) are higher when compared with those of transoesophageal echocardiogram and TTE (74–100% and 71–91%, respectively) 11, 12, 13, 14, 15. In some studies, surgery for TAD, postmortem examination, or sudden death were used to assess the aortic phenotype.…”

Section: Methodsmentioning

confidence: 99%

Systematic Review of Studies That Have Evaluated Screening Tests in Relatives of Patients Affected by Nonsyndromic Thoracic Aortic Disease

Mariscalco

Debiec

Elefteriades

et al. 2018

JAHA

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BackgroundNonsyndromic thoracic aortic diseases (NS‐TADs) are often silent entities until they present as life‐threatening emergencies. Despite familial inheritance being common, screening is not the current standard of care in NS‐TADs. We sought to determine the incidence of aortic diseases, the predictive accuracy of available screening tests, and the effectiveness of screening programs in relatives of patients affected by NS‐TADs.Methods and ResultsA systematic literature search on PubMed/MEDLINE, Embase, and the Cochrane Library was conducted from inception to the end of December 2017. The search was supplemented with the Online Mendelian Inheritance in Man database. A total of 53 studies were included, and a total of 2696 NS‐TAD relatives were screened. Screening was genetic in 49% of studies, followed by imaging techniques in 11% and a combination of the 2 in 40%. Newly affected individuals were identified in 33%, 24%, and 15% of first‐, second‐, and third‐degree relatives, respectively. Familial NS‐TADs were primarily attributed to single‐gene mutations, expressed in an autosomal dominant pattern with incomplete penetrance. Specific gene mutations were observed in 25% of the screened families. Disease subtype and genetic mutations stratified patients with respect to age of presentation, aneurysmal location, and aortic diameter before dissection. Relatives of patients with sporadic NS‐TADs were also found to be affected. No studies evaluated the predictive accuracy of imaging or genetic screening tests, or the clinical or cost‐effectiveness of an NS‐TAD screening program.ConclusionsFirst‐ and second‐degree relatives of patients affected by both familial and sporadic NS‐TADs may benefit from personalized screening programs.

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Section: Methodsmentioning

confidence: 99%

Systematic Review of Studies That Have Evaluated Screening Tests in Relatives of Patients Affected by Nonsyndromic Thoracic Aortic Disease

Mariscalco

Debiec

Elefteriades

et al. 2018

JAHA

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“…Acute aortic dissection and intramural hematoma share similar clinical features and complications, but have different pathophysiological mechanisms. 2 Acute aortic dissection is characterized by the presence of an entry tear that typically occurs spontaneously, whereas intramural hematoma is caused by the rupture of vasa vasorum in the media. IMH can, however, progress to dissection if the intimal layer ruptures.…”

Section: Management Of Acute Aortic Syndromesmentioning

confidence: 99%

Can FDG-PET imaging play a role in guiding indications to endovascular treatments in patients presenting acute aortic syndromes?

Soussan

Hyafil

2019

Journal of Nuclear Cardiology

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“…Together with intramural haematoma and aortic dissection they compose the acute aortic syndromes [1]. These entities usually involve the disruption of the aortic media and present acutely with chest pain or haemodynamic instability [1].…”

Section: Introductionmentioning

confidence: 99%

A Rare Case of a Penetrating Aortic Ulcer Due to Neisseria Gonorrhoeae

2017

CCCS

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Infectious aortitis is an extremely rare condition with an insidious presentation. Here we describe an unusual case of a penetrating ulcer in the ascending aorta that was caused by a chronic Neisseria gonorrhoea infection. The case illustrates the importance of taking a detailed sexual history of patients presenting with aortitis and the value of molecular microbiological techniques for establishing an accurate diagnosis.

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Acute Aortic Dissection and Intramural Hematoma

Cited by 415 publications

References 69 publications

Systematic Review of Studies That Have Evaluated Screening Tests in Relatives of Patients Affected by Nonsyndromic Thoracic Aortic Disease

Systematic Review of Studies That Have Evaluated Screening Tests in Relatives of Patients Affected by Nonsyndromic Thoracic Aortic Disease

Can FDG-PET imaging play a role in guiding indications to endovascular treatments in patients presenting acute aortic syndromes?

A Rare Case of a Penetrating Aortic Ulcer Due to Neisseria Gonorrhoeae

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