During the 2022 FIFA World Cup, there was shock when the talented US sportswriter Grant Wahl died after an aortic dissection. The cause of aortic dissections in young healthy individuals is often a genetic predisposition towards failure of the extracellular matrix, the structure that gives strength to the aortic wall. Dissections of the ascending aorta are associated with high mortality rates and are a leading cause of sudden cardiac death. Despite the severity of the condition, the management of aortic aneurysm and dissection has not changed greatly in decades. Antihypertensives are used to slow the growth of aortic aneurysms, and when an aneurysm becomes too large, prophylactic surgery is recommended to prevent aortic dissection. Most dissections are preceded by aortic enlargement, which allows a window for identification of at-risk individuals. However, universal imaging is impractical and, therefore, most ascending aortic aneurysms are incidentally identified at the time of imaging for other purposes. New methods of predicting and treating individuals at risk of aortic dissections are needed.
Read the full article in The Lancet.