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Forum Name: Diseases of the Aorta

Question: Aortic Aneurysm caused by Cystic Medial Necrosis


 Anonymous - Sat Dec 28, 2002 8:17 am

What is Cystic Medial Necrosis? My husband, 39 yrs old, just underwent an emergency Ascending Aorta Dissection. The pathology report says the aneurysm was caused from Cystic Medial Necrosis.
 Dr. Yasser Mokhtar - Sun Feb 09, 2003 6:42 pm

User avatar Dear guest,

Thank you very much for using our website.

The aorta is the largest vessel of the body. Its wall is formed of 3 layers. The innermost one (the one in direct contact with the blood) is called the intima. The one just outside of it is called the media (and this is the most important one to maitain the integrity of the aorta). The outermost one is called the adventitia. The media is formed of elastic tissue and some fibrous tissue.

Cystic medial necrosis is a term meaning that there was degeneration in the middle layer, the media, and hence the name medial.

The young age of your husband makes me think (unless he has had high blood pressure for a ling time) that he has one of the congenital diseases that causes degeneration of the tissues forming the media of the aorta. The most common one is called Marfan's syndrome. Another one is called Ehlers-Danlos syndrome.

Patients who have these diseases are prone to aortic dissection because of degeneration of the middle layer and they become more susciptible to injury of noirmal stress imposed on the aortic wall by normal blood pressure and they get dissection in the wall of the aorta which means simply that the aortic wall split into two.

Dissection of the ascending aorta is a medical emergency that is life threatening as you already might have known from your personal experience with your husband.

If your husband has either of the two diseases that i mentionned earlier, then he will be maintained on life long medications and he should be monitored regularly.

Once more thank you very much for using our website http://doctorslounge.com and if you still have any questions, please don't hesitate to post them.

Yasser Mokhtar, M.D.

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