A cardiologist yesterday urged people with a family history of aortic dissection to be extra vigilant as research has confirmed a strong hereditary link, with a person’s risk increasing 6.82 times if a first-degree relative experienced the condition.
About five to 10 people per 100,000 in Taiwan are diagnosed each year with aortic dissection, or nearly 2,000 people, Linkou Chang Gung Memorial Hospital cardiologist Chen Shao-wei (陳紹緯) said.
Fifty percent of the cases lead to sudden death, Chen added.
In a three-year study, a research team at the hospital used the National Health Insurance Research Database to analyze 23,868 patients with aortic dissection and Taiwan’s 4.56 million families, Chen said.
The results showed that genetic factors contributed to more than half of the cases, he said.
The aorta — which has three layers: the intima, media and adventitia — is responsible for transporting blood from the heart to major blood vessels throughout the body, he said.
Aortic dissection is when the wall of the aorta in the intima layer splits, Chen said, adding that the splitting allows blood to also pass into the media and adventitia layers, dividing the aorta into two parts, known as the true and false lumens.
If the wall ruptures and blood passes through the false lumen, aortic hemorrhage and dissection occur, he said, adding that the condition is a common cause of sudden death.
Type A dissection requires urgent surgery or there is an 80 to 90 percent chance of dying within a year, he said.
The mortality rate is about 1 percent per hour during the first 24 hours, or initial stage, of the condition, he added.
Type B dissection can generally be managed through medication, as long as there are no complications, he said.
Even with complications, patients with a type B dissection can be treated using a new method where a stent is inserted through a peripheral blood vessel, he said.
A small wire tube keeps the aorta open and stops blood from passing through the dissected wall, he added.
People with family members who had the condition should consult with a doctor and undergo imaging checks, in addition to strictly monitoring their blood pressure and quitting unhealthy habits, such as smoking, Chen added.
Both types of aortic dissection, even when treated, could over time result in the person having an aortic aneurysm, so people who have had an aortic dissection and been treated still need to continually monitor their health, he said.
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