Quick Facts:

  • The aorta is the main blood vessel carrying blood from the heart to the rest of the body.
  • An aortic aneurysm is a widening, bulge, or ballooning of a portion of the aorta.
  • An aortic dissection is a tear between the layers of the aorta, which can cause an aneurysm or rupture.
  • Approximately 10,000 people experience aortic dissections annually.
  • Fast, accurate diagnosis of dissection is imperative: 50% of patients with undiagnosed aortic dissection die within 48 hours, a death rate of approximately 1% per hour.

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Who is at risk?

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Many people may be at risk of aortic disease and not even know it.

Risk factors include:

  • A personal or family history of thoracic aortic If you or a family member is living with an aneurysm or if you have a family member who has had an aortic dissection, you are at an increased risk for thoracic aortic dissection. You and your other family members should be evaluated to determine if a predisposition for aortic aneurysm and dissection exists in the family.
  • Certain genetic syndromes. These genetic syndromes greatly increase your risk for thoracic aortic disease and a potentially fatal aortic dissection: Marfan syndrome, Loeys-Dietz syndrome, Turner syndrome, and vascular Ehlers-Danlos syndrome.
  • Bicuspid aortic valve disease. If you have a bicuspid aortic valve (two leaflets instead of the typical three), or have had a bicuspid aortic valve replaced, you need to be monitored for thoracic aortic disease.
  • Lifestyle and trauma can trigger aortic dissection. It is possible to trigger an aortic dissection through injury to the chest, extreme straining associated with body building, illicit drug abuse, poorly controlled high blood pressure, or by discontinuing necessary blood pressure medications.
  • Rarely, pregnancy can trigger an aortic dissection. However, women with aortic aneurysms and connective tissue disorders who are pregnant are at higher risk of aortic dissection during late pregnancy and delivery and should be carefully monitored by a cardiovascular specialist. However, in women under the age of 40 who experience a dissection, up to 50% occur during pregnancy. Arterial dissection and/or rupture may occur with the highest incidence in the third trimester (approximately 50%) and peripartum period (33%). Type A and B dissections can occur in women with aortic root enlargement and either Marfan syndrome or bicuspid aortic valve up to three months postpartum, and 50% of type B dissections in women occur during the postpartum period. Women with Ehlers-Danlos syndrome-vascular type are at increased risk of vessel rupture at delivery or in the postpartum period. Women who carry a mutation in the ACTA2 gene are at increased risk of peripartum aortic dissection. Therefore, women with aortic aneurysms, bicuspid aortic valves, connective tissue disorders, Turner syndrome, and mutations in genes which predispose to familial thoracic aortic aneurysms/dissections who are pregnant should be carefully followed by a cardiovascular specialist during pregnancy and postpartum to monitor aortic size and growth.

Ritter rules

Named for the late actor John Ritter who died of a thoracic aortic dissection, The Ritter Rules were developed to help you understand your risk and what you can do about it. Read more.

Genetic risk factors