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Ann Thorac Surg 1990;49:638-642
© 1990 The Society of Thoracic Surgeons

Articles

Ascending aortic dissection in weight lifters with cystic medial degeneration

Christian de Virgilio, MD, Ronald J. Nelson, MD, Jeffrey Milliken, MD, Ramon Snyder, MD, Frances Chiang, MD, William D. MacDonald, MD, John M. Robertson, MD*

Departments of Surgery, Pathology, and Radiology, Los Angeles County Harbor-UCLA Medical Center, Torrance, California USA

Accepted for publication December 6, 1989.

* Address reprint requests to Dr Robertson, Department of Surgery, Harbor-UCLA Medical Center, 1000 W Carson St, Bin 423, Torrance, CA 90509.

We report 4 cases of ascending aortic dissection in patients with long histories of weight lifting. In 2 of the patients, the initial symptoms of dissection developed while they were lifting weights. Two patients had a history of hypertension and 2 had previously used anabolic steroids. All 4 were successfully treated surgically. Histopathology showed aortic medial changes in all 4. We believe that the hemodynamic stresses of weight lifting, namely, a rapid increase in systemic arterial blood pressure without a decrease in total peripheral vascular resistance, in combination with aortic medial degeneration may have contributed to the development of the aortic dissection.




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