Role of Exertion or Emotion as Inciting Events for Acute Aortic Dissection

Ioannis S. Hatzaras, Jesse Bible, George J. Koullias, Maryann Tranquilli, Mansher Singh, John A. Elefteriades

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

It is well known that hypertension, aortic dilatation, and collagen disorders predispose to acute aortic dissection (AAD). The inciting events that precede the instant of AAD are incompletely understood. One hundred seventy-five consecutive patients having AAD, treated at our institution during a 10-year period, were reviewed; 65 were women and 110 were men (mean age 61 years). The ascending aorta was affected in 110 patients, and the descending in 65. Information was collected using patients' charts supplemented with direct telephone interviews. Ninety patients were contacted; 65 (24 women, 41 men, mean age 61 years, average aortic size 5.56 cm) could recall specific inciting events for their dissection. In 34 patients, the ascending aorta was involved and in 31 the descending. Eighteen patients (28%) had a positive family history of aortic disease, defined as having ≥1 first-degree relative with aortic disease (aneurysm or dissection). In 24 of the 90 patients contacted (27%), strenuous activity was identified as a clear precipitating factor before the acute onset of thoracic pain; in 36 of 90 (40%) severe emotional stress preceded the onset of dissection pain. Three dissections were iatrogenic. Two additional patients reported a severe exacerbation of chronic obstructive pulmonary disease before their acute onset of chest pain. In conclusion, severe physical and emotional stress may precipitate AAD, presumably on the basis of a transient, severe hypertensive reaction.

Original languageEnglish (US)
Pages (from-to)1470-1472
Number of pages3
JournalAmerican Journal of Cardiology
Volume100
Issue number9
DOIs
StatePublished - Nov 1 2007

Fingerprint

Dissection
Emotions
Aortic Diseases
Chest Pain
Psychological Stress
Aorta
Precipitating Factors
Aortic Aneurysm
Chronic Obstructive Pulmonary Disease
Dilatation
Collagen
Interviews
Hypertension
Pain

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Hatzaras, I. S., Bible, J., Koullias, G. J., Tranquilli, M., Singh, M., & Elefteriades, J. A. (2007). Role of Exertion or Emotion as Inciting Events for Acute Aortic Dissection. American Journal of Cardiology, 100(9), 1470-1472. https://doi.org/10.1016/j.amjcard.2007.06.039
Hatzaras, Ioannis S. ; Bible, Jesse ; Koullias, George J. ; Tranquilli, Maryann ; Singh, Mansher ; Elefteriades, John A. / Role of Exertion or Emotion as Inciting Events for Acute Aortic Dissection. In: American Journal of Cardiology. 2007 ; Vol. 100, No. 9. pp. 1470-1472.
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Hatzaras, IS, Bible, J, Koullias, GJ, Tranquilli, M, Singh, M & Elefteriades, JA 2007, 'Role of Exertion or Emotion as Inciting Events for Acute Aortic Dissection', American Journal of Cardiology, vol. 100, no. 9, pp. 1470-1472. https://doi.org/10.1016/j.amjcard.2007.06.039

Role of Exertion or Emotion as Inciting Events for Acute Aortic Dissection. / Hatzaras, Ioannis S.; Bible, Jesse; Koullias, George J.; Tranquilli, Maryann; Singh, Mansher; Elefteriades, John A.

In: American Journal of Cardiology, Vol. 100, No. 9, 01.11.2007, p. 1470-1472.

Research output: Contribution to journalArticle

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