The coexistence of acute aortic dissection with autosomal dominant polycystic kidney disease--description of two hypertensive patients.
BACKGROUND
Acute aortic dissection is a rare but potentially lethal disease characterized by high early mortality when left untreated. However, survival may be significantly improved by the timely institution of appropriate medical and/or surgical therapy. Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary disorders, accounting for 8-10% of the cases of end-stage renal disease. Hypertension occurs frequently and is an early manifestation of ADPKD in approximately 50-70% of non-azotemic patients. ADPKD, often caused by mutations in the PKD1 gene, is associated with life-threatening vascular abnormalities that are commonly attributed to the frequent occurrence of hypertension.


METHODS
We present two cases of hypertensive patients with acute aortic dissection (type A Stanford) coexisting with ADPKD.


RESULTS
A 54-year-old male hypertensive patient and a 47-year-old male hypertensive patient, both with known ADPKD were diagnosed and operated with acute dissection of ascending aorta. Both patients were characterized by severe hypertension; therefore, in both cases, degree of hypertension is likely to be causative for this vascular complication. However, since ADPKD is associated with the vascular complications mentioned above, abnormality of the structure of the arterial wall of the thoracic aorta cannot be ruled out.


CONCLUSIONS
Aortic dissection is a rare but potentially disastrous complication, and clinicians should always consider this when dealing with patients with ADPKD who present with chest pain or collapse.
Peczkowska
Mariola
M
Department of Hypertension, Institute of Cardiology, Warsaw, Poland.
Januszewicz
Andrzej
A
Grzeszczak
Władysław
W
Moczulski
Dariusz
D
Janaszek-Sitkowska
Hanna
H
Kabat
Marek
M
Biederman
Andrzej
A
Hendzel
Piotr
P
Prejbisz
Aleksander
A
Cendrowska-Demkow
Iwona
I
Zieliński
Tomasz
T
Januszewicz
Magdalena
M
D000784:Aortic Dissection / Q000209:etiology* / Q000601:surgery; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications* / Q000235:genetics