Yamasaki Manabu, Yamamoto Kaori, Abe Kohei, Nakamura Ryota, Tamaki Rihito, Misumi Hiroyasu
Department of Cardiovascular Surgery, St. Luke's International Hospital, Tokyo, Japan.
Department of Diabetes and Endocrinology, St. Luke's International Hospital, Tokyo, Japan.
J Cardiol Cases. 2022 May 24;26(2):154-156. doi: 10.1016/j.jccase.2022.04.013. eCollection 2022 Aug.
Although acute type A aortic dissection is relatively rare in young adults, patients with connective tissue diseases are at a higher risk for developing this condition. To the best of our knowledge, type A aortic dissection due to endocrine diseases has been rarely reported. Here, we present a case of acute type A aortic dissection due to primary aldosteronism in a young man with adrenal adenoma. Total arch replacement was successfully performed. Postoperative imaging and endocrine evaluation revealed an adrenal adenoma. This study highlights the importance of considering primary aldosteronism as a potential etiology of acute aortic dissection in young adults.
Generally, direct or indirect causes of acute type A aortic dissection (ATAAD) are highly diversified. We tend to suspect the familial aortic diseases such as Marfan syndrome when patients with ATAAD are young adults. By contrast, it is useful to know that endocrine diseases such as primary aldosteronism with functional adenoma can be risk factors of ATAAD in young adults.
虽然急性A型主动脉夹层在年轻人中相对少见,但结缔组织病患者发生这种疾病的风险较高。据我们所知,内分泌疾病导致的A型主动脉夹层鲜有报道。在此,我们报告一例因原发性醛固酮增多症合并肾上腺腺瘤导致急性A型主动脉夹层的年轻男性病例。成功实施了全弓置换术。术后影像学检查和内分泌评估发现了肾上腺腺瘤。本研究强调了将原发性醛固酮增多症视为年轻成人急性主动脉夹层潜在病因的重要性。
一般来说,急性A型主动脉夹层(ATAAD)的直接或间接病因高度多样化。当ATAAD患者为年轻成人时,我们往往会怀疑家族性主动脉疾病,如马凡综合征。相比之下,了解诸如功能性腺瘤所致原发性醛固酮增多症等内分泌疾病可能是年轻成人ATAAD的危险因素是很有用的。