Rheumatic heart disease

Congenital heart disease (e.g., bicuspid aortic valve, prolapsed aortic cusp with supracristal ventricular septal defect)

Collagen vascular diseases (e.g., systemic lupus erythematosus)

Connective tissue disease (e.g., Marfan syndrome, Turner's syndrome, pseudoxanthoma elasticum, ankylosing spondylitis, Ehlers-Danlos syndrome, polymyalgia rheumatica)

Ascending aortic aneurysm

Aortitis (e.g., syphilis, Takayasu's arteritis, granulomatous aortitis)

Myxomatous aortic valve*

Calcific changes in aortic valve (together with aortic stenosis)

Anorectic drugs

Infective endocarditis*

Aortic dissection*

Trauma*