T Nation

Weight Lifting & Aortic Dissection

"this is an interesting piece of abstract that was posted on www.flexonline.com

''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.’’

Just in case anyone wanted to know:

What is aortic dissection?

The aorta is the major artery that carries blood from the heart to the rest of the body. Aortic dissection occurs when the inner layer of the aorta?s artery wall splits open (dissects). This is more likely to occur where pressure on the artery wall from blood flow is high. One such place is the ascending aorta (the first segment of the aorta), where the aorta originates from the heart?s left ventricle (pumping chamber). This is the part of the aorta closest to the heart (thus the name proximal aorta).

When the aortic wall splits, the pulses of blood get inside the artery wall and under the inner layer. This makes the aorta split further. This tear usually continues distally (away from the heart) down the descending aorta and into its major branches. Less often the tear may run proximally (back toward the heart).

Aortic dissection can also start in the descending (distal) segment of the aorta.

What are the symptoms of aortic dissection?

Acute aortic dissection causes sudden chest pain. This pain is often described as very severe and tearing; it?s associated with cold sweat. The pain may be localized to the front or back of the chest. Typically the pain moves as the dissection gets worse. Other symptoms and signs depend on the arterial branches involved and compression of nearby organs.

Who is prone to have aortic dissection?

Men have aortic dissection more often than women do. The male-to-female ratio ranges from 2:1 to 5:1. The peak age of occurrence of proximal dissection is between ages 50 and 55. Distal dissection occurs most often between ages 60 and 70. High blood pressure is the most common factor predisposing the aorta to dissection. It?s implicated in 62-78 percent of cases.