CFM Cardiology Practice Test

Aortic dissection occurs when the aortic wall is either structurally weakened or subjected to sudden, high wall stress. Diabetes mellitus does not belong to the usual list of risk factors for dissection; in fact, it’s not typically associated with this condition and some data suggest it may even have a neutral or protective association. Hypertension is the most common modifiable risk factor because chronic high blood pressure increases shear stress on the aortic wall, promoting an intimal tear and dissection. Pregnancy adds risk due to the cardiovascular changes—higher blood volume and cardiac output, along with hormonal effects—that can strain the aorta, especially in the presence of a dilated or weakened root. Connective tissue disorders, such as Marfan or Ehlers-Danlos syndromes, predispose to dissection through intrinsic weakness of the aortic media, making it prone to tearing under normal or increased stress. So diabetes mellitus is not listed as a risk factor, whereas hypertension, pregnancy, and connective tissue disorders are.