Both chronic and acute diseases of the aorta, including trauma, are attracting
increasing attention both in the light of an ageing Western population and with
the advent of modern diagnostic modalities and therapeutic options to manage
aortic pathology. For aortic aneurysm, an individual rate of expansion and the
risk of rupture may be assessed from co-morbidities, hypertensive state, or
connective tissue disease, and may be quantified regardless of anatomic
location for timely selection and treatment. Acute aortic syndrome, a new term
comprising acute dissection, intramural haematoma, and penetrating aortic
ulcers, may share common ground by the observation of microapoplexy of the
aortic wall, eventually leading to higher wall stress, facilitating progressive
dilatation, intramural haemorrhage, dissection, and rupture; chronic
hypertension and connective tissue disorders are likely to promote this
mechanism as well....