Methamphetamine as a risk factor for acute aortic dissection

Acute aortic dissections are catastrophic vascular events that have a high rate of mortality. Aortic dissections have been associated with a variety o f factors, particularly hypertension. We reviewed 84 medical examiner autop sies on individuals dying from acute aortic dissections with particular emp hasis on the role of drugs. Previous case reports have associated aortic di ssections with both cocaine and methamphetamine intoxication. We found that seven of the 35 cases tested for drugs of abuse were positive for methamphetamine. Our study had no cases of solely cocaine-related diss ection, although one of the casts was positive for both methamphetamine and the cocaine metabolite benzoylecgonine. No significant association was fou nd with any other drugs. As with other studies, we found the most common ri sk factor to be hypertension. Surprisingly, methamphetamine use was the sec ond most common risk factor. The association between methamphetamine use an d aortic dissection is most likely due to its hypertensive effect. Although methamphetamine appears to pose a greater risk than cocaine, both drugs sh ould be considered as possible factors in all aortic dissections.