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Aortic aneurysm, familial thoracic 4(AAT4)

MedGen UID:
338704
Concept ID:
C1851504
Disease or Syndrome
Synonyms: AAT4; Aortic aneurysm/aortic dissection and patent ductus arteriosus; MYH11-Related Thoracic Aortic Aneurysms and Aortic Dissections
 
Gene (location): MYH11 (16p13.11)
 
Monarch Initiative: MONDO:0007568
OMIM®: 132900

Definition

Any familial thoracic aortic aneurysm and aortic dissection in which the cause of the disease is a mutation in the MYH11 gene. [from MONDO]

Clinical features

From HPO
Aortic regurgitation
MedGen UID:
8153
Concept ID:
C0003504
Disease or Syndrome
An insufficiency of the aortic valve, leading to regurgitation (backward flow) of blood from the aorta into the left ventricle.
Carotid artery stenosis
MedGen UID:
785
Concept ID:
C0007282
Disease or Syndrome
Narrowing of the carotid arteries.
Coronary artery atherosclerosis
MedGen UID:
3623
Concept ID:
C0010054
Disease or Syndrome
Reduction of the diameter of the coronary arteries as the result of an accumulation of atheromatous plaques within the walls of the coronary arteries, which increases the risk of myocardial ischemia.
Patent ductus arteriosus
MedGen UID:
4415
Concept ID:
C0013274
Congenital Abnormality
In utero, the ductus arteriosus (DA) serves to divert ventricular output away from the lungs and toward the placenta by connecting the main pulmonary artery to the descending aorta. A patent ductus arteriosus (PDA) in the first 3 days of life is a physiologic shunt in healthy term and preterm newborn infants, and normally is substantially closed within about 24 hours after bith and completely closed after about three weeks. Failure of physiologcal closure is referred to a persistent or patent ductus arteriosus (PDA). Depending on the degree of left-to-right shunting, PDA can have clinical consequences.
Stroke disorder
MedGen UID:
52522
Concept ID:
C0038454
Disease or Syndrome
Sudden impairment of blood flow to a part of the brain due to occlusion or rupture of an artery to the brain.
Bicuspid aortic valve
MedGen UID:
57436
Concept ID:
C0149630
Congenital Abnormality
Aortic valve disease-2 (AOVD2) is characterized by bicuspid aortic valve (BAV) and dilation of the ascending aorta. Calcification of the valve and the aorta has been observed, and some patients exhibit coarctation of the aorta (Tan et al., 2012; Luyckx et al., 2019; Park et al., 2019). For a general phenotypic description and a discussion of genetic heterogeneity of aortic valve disease, see AOVD1 (109730).
Thoracic aortic aneurysm
MedGen UID:
56525
Concept ID:
C0162872
Anatomical Abnormality
An abnormal localized widening (dilatation) of the thoracic aorta.
Abnormal left ventricular function
MedGen UID:
69237
Concept ID:
C0242698
Pathologic Function
Inability of the left ventricle to perform its normal physiologic function. Failure is either due to an inability to contract the left ventricle or the inability to relax completely and fill with blood during diastole.
Aortic dissection
MedGen UID:
83315
Concept ID:
C0340643
Disease or Syndrome
Aortic dissection refers to a tear in the intimal layer of the aorta causing a separation between the intima and the medial layers of the aorta.
Ascending tubular aorta aneurysm
MedGen UID:
163631
Concept ID:
C0856747
Anatomical Abnormality
An abnormal localized widening (dilatation) of the tubular part of the ascending aorta.
Anterior cerebral artery stenosis
MedGen UID:
760199
Concept ID:
C1504567
Disease or Syndrome
Narrowing or constriction of the inner surface (lumen) of the anterior cerebral artery.
Middle cerebral artery stenosis
MedGen UID:
760200
Concept ID:
C1504568
Disease or Syndrome
Narrowing or constriction of the inner surface (lumen) of the middle cerebral artery.
Posterior cerebral artery stenosis
MedGen UID:
760201
Concept ID:
C1504569
Disease or Syndrome
Narrowing or constriction of the inner surface (lumen) of the posterior cerebral artery.
Ascending aortic dissection
MedGen UID:
322966
Concept ID:
C1836653
Disease or Syndrome
A separation of the layers within the wall of the ascending aorta. Tears in the intimal layer result in the propagation of dissection (proximally or distally) secondary to blood entering the intima-media space.
Descending aortic dissection
MedGen UID:
868484
Concept ID:
C4022878
Disease or Syndrome
A separation of the layers within the wall of the descending aorta. Tears in the intimal layer result in the propagation of dissection (proximally or distally) secondary to blood entering the intima-media space.
Cystic medial necrosis
MedGen UID:
1638446
Concept ID:
C4551473
Disease or Syndrome
A disorder of large arteries, in particular the aorta, characterized by an accumulation of basophilic ground substance in the media with cyst-like lesions associated with degenerative changes of collagen, elastin and the vascular smooth muscle cells.
Livedo reticularis
MedGen UID:
43223
Concept ID:
C0085642
Disease or Syndrome
Livedo reticularis is characterized by the presence of a bluish purple, mottled or netlike pattern in unbroken circles on the skin. Exposure to cold environments usually intensifies the vascular pattern. Presumably, the condition results from slow or stagnant blood flow, vessel-wall pathology, and decreased oxygen tension.
Abnormal iris pigmentation
MedGen UID:
331733
Concept ID:
C1834387
Finding
Abnormal pigmentation of the iris.

Recent clinical studies

Etiology

Núñez-Gil IJ, Bautista D, Cerrato E, Salinas P, Varbella F, Omedè P, Ugo F, Ielasi A, Giammaria M, Moreno R, Pérez-Vizcayno MJ, Escaned J, De Agustin JA, Feltes G, Macaya C, Fernández-Ortiz A; Registry on Aortic Iatrogenic Dissection (RAID) Investigators
Circulation 2015 Jun 16;131(24):2114-9. Epub 2015 Apr 17 doi: 10.1161/CIRCULATIONAHA.115.015334. PMID: 25888682

Diagnosis

Núñez-Gil IJ, Bautista D, Cerrato E, Salinas P, Varbella F, Omedè P, Ugo F, Ielasi A, Giammaria M, Moreno R, Pérez-Vizcayno MJ, Escaned J, De Agustin JA, Feltes G, Macaya C, Fernández-Ortiz A; Registry on Aortic Iatrogenic Dissection (RAID) Investigators
Circulation 2015 Jun 16;131(24):2114-9. Epub 2015 Apr 17 doi: 10.1161/CIRCULATIONAHA.115.015334. PMID: 25888682

Therapy

Núñez-Gil IJ, Bautista D, Cerrato E, Salinas P, Varbella F, Omedè P, Ugo F, Ielasi A, Giammaria M, Moreno R, Pérez-Vizcayno MJ, Escaned J, De Agustin JA, Feltes G, Macaya C, Fernández-Ortiz A; Registry on Aortic Iatrogenic Dissection (RAID) Investigators
Circulation 2015 Jun 16;131(24):2114-9. Epub 2015 Apr 17 doi: 10.1161/CIRCULATIONAHA.115.015334. PMID: 25888682

Prognosis

Núñez-Gil IJ, Bautista D, Cerrato E, Salinas P, Varbella F, Omedè P, Ugo F, Ielasi A, Giammaria M, Moreno R, Pérez-Vizcayno MJ, Escaned J, De Agustin JA, Feltes G, Macaya C, Fernández-Ortiz A; Registry on Aortic Iatrogenic Dissection (RAID) Investigators
Circulation 2015 Jun 16;131(24):2114-9. Epub 2015 Apr 17 doi: 10.1161/CIRCULATIONAHA.115.015334. PMID: 25888682

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