title: [Aortic aneurysms and aortic dissection: epidemiology, pathophysiology and diagnostics].
abstract: Aortic aneurysms and aortic dissection represent a significant health risk due to the demographic developments and current life styles. The mortality of ruptured aortic aneurysms is up to 80 % and the prevalence of aneurysms varies depending on the localization (thoracic or abdominal). Most commonly affected is the infrarenal abdominal aorta; however, there is evidence that the prevalence is diminishing but in contrast the incidence of thoracic aortic aneurysms is increasing. Aortic dissection is often fatal and is the most common acute aortic disease but the incidence is presumed to be underestimated. The pathogenesis of aortic aneurysms is manifold and is based on an interplay between degenerative, proteolytic and inflammatory processes. An aortic dissection arises from a tear in the intima which results in a separation of the aortic wall layers with infiltration of bleeding and the danger of aortic rupture. Various genetic disorders of connective tissue promote degeneration of the aortic media, most notably Marfan syndrome. Risk factors for aortic aneurysms and aortic dissection are nicotine abuse, arterial hypertension, age and male gender. Aortic aneurysms initially have an uneventful course and as a consequence are mostly discovered incidentally. The clinical course and symptoms of aortic dissection are very much dependent on the section of the aorta affected and the manifestations are manifold. Acute aortic dissection is in 80 % of cases first manifested as sudden extremely severe pain. The diagnostics and subsequent course control can be achieved by a variety of imaging procedures but the modality of choice is computed tomography.
authors.affiliation: Schweizerisches Herz- und Gefässzentrum, Abteilung für Klinische und Interventionelle Angiologie, Inselspital, Universität Bern, Freiburgstr., 3010 Bern, Schweiz.
authors.forename: F
authors.initials: F
authors.lastname: Baumann
authors.forename: V
authors.initials: V
authors.lastname: Makaloski
authors.forename: N
authors.initials: N
authors.lastname: Diehm
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D013504:Cardiovascular Surgical Procedures / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015996:Survival Rate
references.citation: Radiology. 2010 Apr;255(1):53-61
references.pmid: 20308444
references.citation: Circulation. 1960 Aug;22:315-25
references.pmid: 13820522
references.citation: Int J Cardiol. 2013 Feb 10;163(1):72-8
references.pmid: 21641667
references.citation: Dtsch Med Wochenschr. 2012 Jun;137(22):1150-2
references.pmid: 22619009
references.citation: Am Heart J. 1998 Dec;136(6):1051-60
references.pmid: 9842019
references.citation: J Vasc Surg. 2008 Mar;47(3):492-8
references.pmid: 18295101
references.citation: Heart Vessels. 2002 Jan;16(2):42-5
references.pmid: 11833840
references.citation: Circulation. 2011 Sep 6;124(10):1118-23
references.pmid: 21844079
references.citation: Am Heart J. 2011 Jul;162(1):38-46.e1
references.pmid: 21742088
references.citation: Arch Intern Med. 2006 Jul 10;166(13):1350-6
references.pmid: 16831999
references.citation: J Vasc Surg. 2007 Sep;46(3):427-33
references.pmid: 17826227
references.citation: Eur J Vasc Endovasc Surg. 2009 May;37(5):531-7
references.pmid: 19297214
references.citation: Circulation. 2004 Jul 6;110(1):16-21
references.pmid: 15210603
references.citation: Am J Cardiol. 2002 Mar 1;89(5):623-6
references.pmid: 11867057
references.citation: Heart. 2001 Apr;85(4):365-8
references.pmid: 11250953
references.citation: Circulation. 2002 Apr 2;105(13):1529-30
references.pmid: 11927514
references.citation: Eur J Vasc Endovasc Surg. 2001 Jun;21(6):535-40
references.pmid: 11397028
references.citation: Eur J Vasc Endovasc Surg. 2009 Feb;37(2):149-59
references.pmid: 19097813
references.citation: Surg Clin North Am. 2009 Aug;89(4):869-93, ix
references.pmid: 19782842
references.citation: J Vasc Surg. 2012 Aug;56(2):311-6
references.pmid: 22503227
references.citation: J Vasc Surg. 2010 Jun;51(6):1479-87
references.pmid: 20488324
references.citation: Lancet. 2012 Feb 4;379(9814):413-31
references.pmid: 22305225
references.citation: Circulation. 2004 Sep 14;110(11 Suppl 1):II237-42
references.pmid: 15364869
references.citation: Circulation. 2005 Feb 15;111(6):816-28
references.pmid: 15710776
references.citation: Ann Thorac Surg. 2006 Oct;82(4):1400-5
references.pmid: 16996941
references.citation: Emerg Radiol. 2002 Nov;9(5):257-61
references.pmid: 15290550