15. Aneurysms

Question 1

An aneurysm is a ___.

Answer 1

localized, blood-filled out pouching in the wall of the artery. The larger it becomes, the more likely it is to rupture. (exam may have a question about abdominal aortic or thoracic aortic aneurysms)

Question 2

Etiology of Aneurysms

Answer 2

-Arteriosclerosis
-Hypertension
-smoking
-obesity
-bacterial infections
-congenital anomalies
-trauma
-Marfan syndrome

Question 3

Abdominal Aortic Aneurysms

Answer 3

75% of all CV-related aneurysms
-asymptomatic if small
-pulsations in the abdominal area
-abdominal or low back pain
-nausea, vomiting
-shock

Question 4

Thoracic Aortic Aneurysms

Answer 4

25% of all CV-related aneurysms
-sudden tearing, ripping pain in chest that radiates to the shoulders, neck, and back
-cough
-hoarseness
-dysphagia
-dyspnea
-dizziness, difficultly walking and speaking
-widening of mediastinum on a chest XR

Question 5

Treatment of Aneurysms: smaller

Answer 5

-Aneurysms that are < 5 cm in diameter and produce no symptoms
-monitor regularly
-ultrasound or CT scan
-treat hypertension: drug class of choice is beta
blockers, which may slow growth
-people with Marfan syndrome are often treated sooner

Question 6

Treatment of Aneurysms: larger

Answer 6

-Thoracic aortic aneurysm that is causing symptoms or is > 6 cm
-surgical repair
-Dissection: SURGERY
-Aggressive trot of hypertension and HR control
-Labetalol drip

Question 7

Aortic Dissection

Answer 7

Blood passes through the inner lining and between the layers of the aorta
-The tear is spiral in nature
-A dissection can occur suddenly or gradally
- A dissection occurs in the ascending aorta or in the aortic arch
-A dissection is life-threatening
- A dissection requires immediate surgical intervention.