Etiology

Hypertension (most common risk factor)

• Approx. 70% of patients with aortic dissection have elevated blood pressure, which can lead to propagation of the dissection and increases the risk of rupture.

• Exception: In patients < 40 years of age, less than 40% of cases are due to hypertension.

Trauma, e.g., deceleration injury in a motor vehicle collision, or iatrogenic injury during valve replacements or graft surgery (traumatic aortic dissection)

Vasculitis with aortic involvement (e.g., syphilis, Takayasu arteritis)

Use of amphetamines and cocaine

Third-trimester pregnancy (or early postpartum period)

Atherosclerosis

Connective tissue disease (Marfan syndrome, Ehlers-Danlos syndrome)

Bicuspid aortic valve (e.g., in Turner syndrome)

Coarctation of the aorta