**3.3 Genetic disorders**

*Differential Diagnosis of Chest Pain*

directions from the site of origin leading to complications including acute aortic insufficiency, cardiac tamponade, and organ ischemia and with disruption of the

Intramural hematoma (IMH) is characterized by bleeding confined to the

Rarely ulceration of an atherosclerotic lesion penetrating to the medial layer may

These three conditions, namely, AD, IMH, and penetrating aortic ulcer, are categorized under the broader category of acute aortic syndrome (AAS) (**Figure 2**) [4].

Factors that increase the risk of aortic dissection in a person's life include the

Aortic dissection tends to occur more in men between 60 and 80 years old, whereas women are generally older than men having aortic dissection [5]. However both men and women can develop these conditions at any age, but in females the outcome is worse. On the other hand, familial aortic dissections occur in younger

Systemic hypertension is the most important predisposing condition for aortic

dissection. It could be either an acute, transient, abrupt rise in blood pressure leading to aortic dissection by various mechanisms like strenuous resistance exercises, weight lifting or illicit use of drugs like cocaine, egotism, and energy drink usage [7, 8]. While chronic or long-term hypertension keeps greater pressure on atherosclerotic arterial walls, leading to intimal tear and aortic aneurysm.

patients as compared to sporadic aortic dissection [6].

medial layer with no intimal tear visualized by current imaging studies.

give rise to a penetrating aortic ulcer with similar consequences as of AD.

adventitial layer may lead to aortic rupture.

**3. Predisposing conditions**

following;

**Figure 2.**

*Acute aortic syndrome.*

**3.1 Age and sex**

**3.2 Hypertension**

**66**

People having specific genetic conditions have a higher incidence of aortic dissection, like Marfan's syndrome, Turners syndrome, Ehlers-Danlos syndrome, annuloaortic ectasia, adult polycystic kidney disease, Noonan syndrome, and osteogenesis imperfecta. Mostly patients with Marfan's syndrome who develop aortic dissection are young, around 40 years old, and have family history of Marfan's syndrome and aortic dissection [9].
