9. MTB Step 3 - Aortic Disease

Question 1

DISSECTION OF THE THORACIC AORTA

What are (3) Presenting Symptoms of Dissection of the Thoracic Aorta?

Answer 1

1. CHEST PAIN Radiating to the Back between the Scapula.
   
   • Very Severe and “Ripping” in nature.
2. Difference in Blood Pressure (BP) between RIGHT and LEFT arms.

Question 2

DISSECTION OF THE THORACIC AORTA

DIAGNOSIS

1. What is the Best INITIAL Test for Dissection of the Thoracic Aorta?
2. What is the Most ACCURATE Test for Dissection of the Thoracic Aorta?

Answer 2

1. Chest X-Ray (CXR) shows a Widened Mediastinum
2. CT Angiography

Question 3

DISSECTION OF THE THORACIC AORTA

TREATMENT

1. What is the Best INITIAL Treatment for Dissection of the Thoracic Aorta?
2. What is the Next Best Treatment for Dissection of the Thoracic Aorta?
3. What is the Most EFFECTIVE Therapy for Dissection of the Aorta?

Answer 3

1. Beta-Blockers
2. Nitroprusside - to control the Blood Pressure
3. Surgical Correction

**Aortic Dissection cases should be placed in the ICU, and Surgical Consultation should be ordered**

Question 4

ABDOMINAL AORTIC ANEURYSM (AAA)

SCREENING

Who should be Screened for AAA and what is the Method of Screening?

Answer 4

65 - 75 yo Men who are CURRENT or FORMER smokers

Screening is with Abdominal Ultrasound (US)

Question 5

ABDOMINAL AORTIC ANEURYSM (AAA)

TREATMENT

1. When should a patient with AAA be Treated?
2. What is the Treatment for AAA?

Answer 5

1. AAA > 5 cm
2. Surgical Repair