Dissecting and Atherosclerotic Aneurysms: A Survey of Post-Mortem Examinations, 1968–77

Abstract

A survey of 10 years of post-mortem examinations (total 21 366) revealed that death was attributed to a dissecting aneurysm in 305 cases. A typical case was an elderly, hypertensive female, in whom dissection started in the ascending aorta and ruptured to produce a haemopericardium; death occurred suddenly at home after a brief episode of chest pain. In the same 10-year period there were 372 ruptured atherosclerotic aneurysms of the aorta. By contrast, a typical case was a male in his 70s, again hypertensive, with rupture in the abdominal portion of the aorta. Death is less sudden in many of these cases and the patient is more likely to have reached hospital. There is no indication of any trend for either of these types of aneurysm to increase in the decade studied. The Registrar General's (1968, 1974, 1976) mortality statistics for England and Wales support this, but show an overall increase in incidence in the past 20 years.