Predisposing causes

The majority of patients with dissection are hypertensive males between the ages of 40 and 70, usually in their sixth or seventh decades. It is more common in the black population than in Caucasians and is relatively rare in orientals. It is more common in Marfan's syndrome and occurs with increased frequency in Ehlers-Danlos, Turner's, and Noonan's syndromes and in patients with bicuspid aortic valves. Such patients tend to develop dissection at a younger age and frequently have no history of arterial hypertension. Rarer associations include pregnancy (usually in the third trimester), vasculitis, and aortic coarctation. Dissection may occasionally follow trauma, aortic instrumentation, cocaine abuse, or aortotomy. Syphilis and atheroma lead to saccular aneurysms rather than dissection.

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