Which populations at risk for an aortic dissection are emergency physicians most likely to encounter?
People with Marfan syndrome are among those at high risk for aortic dissection. In addition, other people who have known or unknown enlargement of the aorta, bicuspid aortic valves, high blood pressure, or have family history of aortic dissections are also at substantially increased risk for aortic dissections. Women with Turner syndrome, a chromosomal condition causing short stature and infertility, are also predisposed to ascending and descending aortic dissections. These groups merit closer attention in an emergency department. Aortic dissection is the primary cause of death in individuals with Marfan syndrome. Through education of the medical and lay communities, it is hoped that individuals with enlarged aortas will have medical and surgical intervention initiated before the aorta tears or ruptures. Physicians in the emergency room should be aware of the classic features of Marfan syndrome: • Disproportionately long arms, legs, fingers and toes • Pectus carinatum • Pectus excavatu
