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Guilt by association: paradigm for detecting a silent killer (thoracic aortic aneurysm)

John A Elefteriades1, Adam Sang1, Gregory Kuzmik1

  • 1Aortic Institute at Yale-New Haven, Boardman 2, Yale University School of Medicine , New Haven, Connecticut , USA.

Open Heart
|May 2, 2015
PubMed

Insights

Identifying thoracic aortic aneurysms can be improved by screening patients with related medical conditions and aortic variants. This approach aims to detect this silent disease earlier, reducing mortality from thoracic aortic aneurysm.

Area of Science:

  • Cardiovascular Medicine
  • Genetics and Genomics
  • Vascular Surgery

Background:

  • Thoracic aortic aneurysm and dissection (TAAD) is a life-threatening condition often diagnosed late.
  • Several medical conditions and aortic anatomic variants are associated with an increased risk of TAAD.
  • Family history of aneurysm disease is a significant risk factor for TAAD.

Purpose of the Study:

  • To review the established associations between various conditions and TAAD.
  • To propose a diagnostic paradigm leveraging these associations for early TAAD detection.
  • To highlight the potential of 'guilt by association' for reducing TAAD-related mortality.

Main Methods:

  • Literature review of studies investigating associations with TAAD.
  • Analysis of medical conditions linked to TAAD.
  • Evaluation of aortic anatomic variants associated with TAAD.

Main Results:

  • Confirmed associations include intracranial aneurysm, abdominal aortic aneurysm, temporal arteritis, autoimmune disorders, and renal cysts.
  • Aortic anatomic variants like bovine aortic arch and bicuspid aortic valve are linked to TAAD.
  • Family history of aneurysm disease is a strong predictor for TAAD.

Conclusions:

  • Patients with identified associated conditions or variants should be screened for silent thoracic aortic aneurysms.
  • Utilizing 'guilt by association' offers a proactive strategy for diagnosing TAAD.
  • This diagnostic approach has the potential to significantly decrease deaths caused by TAAD.

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