Your aorta can tell you a lot about your family history.
Give me 5 minutes with a patient and I can get a very good sense of how likely it is that they have a problem with their aorta. Dr. Grayson Wheatley
It’s true — you carry around your family history in your aorta.
Let’s start from the beginning. Your aorta is the major blood vessel of the body. It connects directly to the heart at the level of the aortic valve and receives all of the blood pumped from the left side of the heart.
From its origin at the level of the heart, the aorta “ascends” in the chest to the base of the neck and then “arches” around and then “descends” down the chest to run the length of the torso. The aorta is immediately adjacent to the spinal column.
The aorta is a large blood vessel — on average an inch or more in diameter — and gives off branches to all vital organs in the body (including the brain).
The aorta is an elastic structure that expands and contracts with every heartbeat.
In order to repeatedly expand and contract and remain durable, the integrity of the aorta must stay viable.
The Aorta Can “Wear Out”
Aortic diseases develop because of a breakdown in the integrity of the elastic tissue within the wall of the aorta.
There are several ways that the elastic tissue in the aorta can “wear out”.
The natural process of aging and generalized weakening of all tissues in the body can affect the aorta, just like it affects the skin. I tell my patients: “Just like we develop wrinkles of the skin as we age, we can similarly develop imperfections of the aorta on the inside. The accumulation of imperfections of the aorta over many years due to aging can result in an aortic aneurysm or aortic dissection.”
Other lifestyle factors can directly affect the aorta — which are very similar to the factors which impact the development of heart disease — which only exacerbate the natural degeneration associated with aging. Those factors are high blood pressure, high blood cholesterol, and tobacco smoking.
Aortic Problems Can Run in Families
However, problems with the aorta can be inherited.
Yes, let me say that again: there are biological traits that you can inherit from your family which can directly result in the development of an aortic aneurysm or propensity for developing an aortic dissection.
This information is critical for everyone to understand.
If anyone in your family (immediate or remote) has ever been treated for an aortic problem, it is imperative that you have a check-up by a heart specialist to assess your risk of having an aortic problem.
There are some genetic markers that we can test for which relate to aortic disease, but we don’t recommend that testing unless there are physical features that are associated with common inherited connective tissue disorders such as Marfan Syndrome.
Most of the inherited conditions that predispose people to develop an aortic problem relate to disorders at the genetic level involving the elastic tissue within the wall of the aorta.
The 6 Most Common Reasons that someone dies suddenly
If you have been told that someone in your family has “died suddenly”, there are usually a few common reasons.
- Heart attack — sudden loss of blood flow to the heart muscle from a blockage in a coronary artery.
- Aortic dissection — a sudden, immediate ripping or tearing of the aorta.
- Ruptured aortic aneurysm — a bursting of the aorta in an area that is weakened, resulting in massive internal bleeding.
- Pulmonary embolus — a blood clot that develops in the veins of the legs and suddenly breaks off and travels to the heart and shuts off blood flow to the lungs.
- Stroke — a blot clot or bleeding in the brain.
- Cardiac arrhythmia — a sudden onset of an abnormal heart rhythm that impairs the ability of the heart to pump
Your family medical history is important
If the cause of death of someone in your family history was diagnosed as resulting from an aortic problem, then you should get checked out for an aortic problem by a heart specialist. Preferably someone with expertise in aortic diseases.
If someone in your family died suddenly from unknown causes, then you should also get checked out by a heart specialist for an aortic problem since one of the potential ways your ancestor may have died suddenly could have been from an aortic problem.
Bottom line: your aorta carries your genetic lineage within its walls and your life could depend on the type of aortic tissue you have in the wall of your aorta from birth.
Quite often if someone has an inherited aortic problem, they develop an aortic disease before the age of 55 years.
If you have a family history of aortic disease, even if your initial evaluation for aortic disease is negative, you should still get screened every 5 years for an aortic problem.
A special situation is for patients with a bicuspid aortic valve. These are people who are born with a structurally abnormal aortic heart valve. This inherited condition predisposes people to develop aneurysms of the ascending aorta at a young age. Screening is important in these patients as well.
Pass this along: you could save someone’s life
Feel free to pass this information along to friends and family members so that we can all work together to prevent unexpected deaths resulting from undiagnosed aortic diseases.
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