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Cystic Medial Necrosis: Definition, Causes & Symptoms

Instructor: Dan Washmuth

Dan has taught college Nutrition, Anatomy, Physiology, and Sports Nutrition courses and has a master's degree in Dietetics & Nutrition.

Cystic medial necrosis is the breakdown or damage of connective tissue of the large arteries throughout the body. Learn about cystic medial necrosis as well as the causes and symptoms of this condition.

Cystic Medial Necrosis

Henry is a 43 year old restaurant manager. During a busy Saturday night at the restaurant, Henry complained of intense pain in his chest and back, then collapsed. An ambulance picked him up and on the way to the hospital, Henry went into shock and lost consciousness.

Fortunately, the medics, doctors, and nurses were able to save Henry's life. When Henry regained consciousness, his doctor informed him that he had a cystic medial necrosis that caused a life-threatening tear in his aorta.

Cystic medial necrosis refers to the breakdown or damage of muscle, collagen, and elastin of large blood vessels throughout the body, most commonly the aorta. The aorta is the main artery in the body through which all oxygenated blood runs before traveling to all other parts of the body.

The aorta is a very large artery that is attached to the heart.
aorta

The muscle, collagen, and elastin of the blood vessels function to provide the vessels with structure and support. If these connective tissues are damaged, the vessels can eventually tear open, causing blood to be lost from the blood vessels. A tear in the aorta caused by cystic medial necrosis is referred to as an aortic dissection. An aortic dissection is a life threatening condition.

Cystic Medial Necrosis: Causes

Often, cystic medial necrosis is the result of a degenerative disease that damages the connective tissue throughout the body. The muscle, collagen, and elastin that are part of the blood vessels can be classified as connective tissue. A degenerative disease that damages connective tissue could result in the breakdown or destruction of the muscle, collagen, and elastin of the blood vessels. This breakdown or destruction is the defining characteristic of cystic medial necrosis.

The degenerative diseases that can break down or damage connective tissues include:

  • Marfan syndrome
  • Ehlers-Danlos syndrome
  • Annuloaortic ectasia

Cystic Medial Necrosis: Symptoms

The most common symptom of cystic medial necrosis is chest pain. However, if the cystic medial necrosis leads to an aortic dissection, the symptoms become much more severe. A person with an aortic dissection usually will have intense pain in the chest and back, vomiting, dizziness, shock, and heavy sweating.

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