Type B AD - risks

Q: Bicuspid aortic valve is protective of type B aortic dissection in young patients? 

A) True

B) False

Answer: B

The objective of this question is to highlight the risk factors of type B aortic dissection (AD) in younger patients. In general type B aortic dissection occurs in older patients but some risk factors can make it a disease of relatively younger patients. Few of the major risk factors are:

• Severe acute hypertension 
• High-intensity exercise
• Drug abuse (particularly cocaine) 
• Connective tissue disorder (most famous - Marfan syndrome)
• Bicuspid aortic valve
• Previous aortic surgery
• Aortic coarctation
• Turner syndrome
• Inflammatory vasculitis (giant cell arteritis, Takayasu arteritis)
• Blunt aortic trauma
• Pregnancy and delivery

#cardio-thoracic

#vascular

References:

1. Luebke T, Brunkwall J. Type B Aortic Dissection: A Review of Prognostic Factors and Meta-analysis of Treatment Options. Aorta (Stamford). 2014 Dec 1;2(6):265-78. doi: 10.12945/j.aorta.2014.14-040. PMID: 26798745; PMCID: PMC4682679.

2. Shalhub S, Roman MJ, Eagle KA, LeMaire SA, Zhang Q, Evangelista A, Milewicz DM; Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC) Consortium. Type B Aortic Dissection in Young Individuals With Confirmed and Presumed Heritable Thoracic Aortic Disease. Ann Thorac Surg. 2020 Feb;109(2):534-540. doi: 10.1016/j.athoracsur.2019.07.004. Epub 2019 Jul 31. PMID: 31376376.