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

While seasonal patterns suggest that 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, particularly perceived as windchill, significantly increased dissection odds by up to 50 percent, peaking three to four 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 may 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 conditions.