7.4 Aortic Dissection, Aneurysm

Question 1

abdominal aortic aneurysm vs ascending aortic aneurysm:

-most common underlying causes?

Answer 1

1. atherosclerosis–abdominal
2. HTN–ascending aorta

Question 2

Why might you see cough with aortic aneurysm?

Answer 2

Thoracic aneurysm may impinge on recurrent laryngeal n

Question 3

Aortic dissection

-Blood enters what vessel layer(s)?

Answer 3

-blood enters media and splits it

Question 4

aortic dissection

-main causes, how?

Answer 4

1. HTN–results in hyaline arteriosclerosis of vasa vasorum of early aorta. This means O2 cannot reach outer layers of the aorta, weakining it.
2. Marfans, Ehlers-Danlos
   - weak media layer

Question 5

aortic dissection

-symptoms

Answer 5

sharp, tearing chest pain, radiates to back

Question 6

aortic dissection

-complications (3)

Answer 6

1. pericardial tamponade
2. obstruction of branching arteries (renal, coronary)
3. bleeding out of vessel

Question 7

thoracic aneurysm

-causes

Answer 7

• tertiary syphillis, causes ‘tree bark’ appearance of aorta from inflammation of small vessels (vasa vasorum of early aorta)
• atherosclerosis (which is main cause in AAA)
• aortic dissection complication

Question 8

thoracic aneurysm

-complications

Answer 8

1. main complication: aortic regurg from aortic root dilation
2. also, compression of mediastinal structures (eg airway, esophagus)

Question 9

abdominal aortic aneurysm

• causes
• main population affected

Answer 9

1. atherosclerosis. O2 cannot diffuse through thickened wall, leading to wall weakening
   - male smokers >60 with HTN