Weathering the Aorta: The Impact of Environmental Factors on Acute Aortic Dissection

While seasonal patterns suggest cold weather influences the incidence of acute type A aortic dissection, the impact of subjective thermal stress on dissection risk remains poorly characterized. This retrospective multicenter study examined environmental triggers of acute type A aortic dissection in 548 German patients between 1996 and 2016. Subjective cold exposure, perceived as wind chill, significantly increased dissection odds by up to 50 percent, peaking 3-4 days before events. Elevated atmospheric pressure and low dew point also increased risk, while lower humidity showed modest protection. The acute temporal pattern suggests that cold-induced sympathetic activation, vasoconstriction, and blood pressure surges precipitate dissection in vulnerable individuals. These interesting findings emphasize that perceived environmental stress outweighs ambient temperature in triggering acute aortic events, highlighting opportunities for targeted prevention during adverse weather.