1. Hypertension: About 50% of patients with aortic dissection have hypertension. In particular, long-term and severe hypertension can increase the impact of hemodynamics on the aortic wall, make the aortic nutrient vessels in a state of spasm and compression, cause ischemia, degeneration, necrosis, elastic fiber breakage, fibrosis and intimal rupture of the middle smooth muscle, and finally form a dissection hematoma.
2. Hereditary diseases of connective tissue: For example, Marfan syndrome, Edwin-Dane syndrome, congenital coarctation of aorta, bicuspid aortic valve and mitral valve prolapse, patients often have hereditary defects of connective tissue in the aortic wall, which are manifested as degeneration of collagen and fibrous tissue in the aortic middle layer, followed by cystic necrosis, and lack of support in the intima, which is easy to cause intima rupture and dissection hematoma.
3. Atherosclerosis: It often occurs in patients with hypertension, hyperlipidemia and hyperglycemia and the elderly. Atherosclerotic plaque ruptures from the lumen, which can form a dissection hematoma.
4. Others: severe aortic trauma, inflammation (syphilitic aortitis, systemic lupus erythematosus, etc. ), late pregnancy and cardiovascular intervention can cause aortic dissection hematoma.
I hope the above reply is helpful to you.