Original Research

Weight Lifting and Aortic Dissection: More Evidence for a Connection
I. Hatzaras, M. Tranquilli, M. Coady, P.M. Barrett, J. Bible, J.A. Elefteriades

Section of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, Conn., USA

Address of Corresponding Author

Cardiology 2007;107:103-106 (DOI: 10.1159/000094530)

  Key Words

• Aorta
• Dissection
• Weight lifting
• Exercise
• Vascular diseases

  Abstract

Background/Aims: In 2003, we reported on a small number of patients in whom acute aortic dissection appeared to be causally related to intense weight lifting. If additional cases could be identified, the phenomenon of weight lifting induced aortic dissection would be further substantiated. We now report a substantially larger number of cases in which aortic dissection is associated with intense physical exertion. Methods: Additional cases of acute aortic dissection occurring at the time of intense physical exertion were accumulated and analyzed. Cases were culled from retrospective review of a large university data base and from reports forwarded to our attention from around the country. We determined type of activity bringing on symptoms, age and sex of the patients, location of the dissection (ascending or descending aorta), aortic size, therapy, and survival. Results: We identified 31 patients in whom acute aortic dissection occurred in the context of severe physical exertion, predominantly weight lifting or similar activities. All patients except one were males. Mean age was 47.3 (range = 19-76). All except four dissections were in the ascending aorta. Only three patients (9.7%) had a family history of aortic disease. Mean aortic diameter on the initial imaging study was 4.63 cm. Twenty-six of the 31 cases were diagnosed ante-mortem and 5 post-mortem. Overall, 10 of the 31 patients (32.2%) died. Of 24 patients reaching surgical therapy, 20 (83.3%) survived. Conclusion: Weight lifting related acute aortic dissection appears to be a real phenomenon, with increasing evidence for the association of extreme exertion with this catastrophic aortic event. Moderate aortic dilatation confers vulnerability to exertion-related aortic dissection. Individuals with known aortic dilatation should be cautioned to refrain from weight lifting or strenuous exertion. Routine echocardiographic screening of individuals engaging in heavy strength training should be considered, in order to prevent this tragic loss of life.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

John A. Elefteriades, MD
Section of Cardiothoracic Surgery
121 FMB, 333 Cedar St.
New Haven, CT 06510 (USA)
Tel. +1 203 785 2705, Fax +1 203 785 3346, E-Mail john.elefteriades@yale.edu

  Article Information

Received: May 8, 2006
Accepted: May 8, 2006
Published online: July 14, 2006
Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 1, Number of References : 6