AAA Flashcards
What are the common causes of AAA?
HYPERTENSION
SMOKING
DIABETES
Also: Age, obesity, high LDL, sedentary, genetics
What are the other causes of AAA?
o Co-arction of the aorta o Marfaans syndrome o Previous aortic surgery o Pregnancy o Trauma o Inflam – Takayasu o Infection – syphilis False aneurysms
what are the causes of false aneurysms?
iatrogenic (post catheter angiogram, orthopaedic surgery, arterial anastomosis), IV drug abuse, trauma
what is a aneurysm
permanent dilatation of the vessel wall
what is a true aneurysm
involves all 3 layers of the arterial wall
what is a false aneurysm?
single layer of fibrous tissue forms the aneurysm wall?
what is the morphology of AAA?
fusiform or saccular
What is the underlying pathophysiology of AAA?
Ischaemia causes loss of elastic tissue due to macrophages
CTD causes change in balance of collagen and elastic fibre
resulting dilation
Where do AAA normally occur?
90% start below the renal artery
How do AAA rupture?
o anteriorly into peritoneal cavity (worse prognosis)
o posteriorly into retroperitoneum
What are the common symptoms of AAA?
Often Asymptomatic
Pain, may mimic renal colic
Trashing (distal atheroemboli from AAA)
Abdominal pain, malaise and weight loss
What are the symptoms of a ruptured AAA?
o sudden onset of epigastric/central abdominal pain
o radiates through to back
o collapse
o Hypotension
o Patient may look well, normotensive/hypertensive
o May mimic renal colic
o Pulsatile, expansile mass +/- tender over AAA
o Transmitted pulse in flanks
o sweating
What is the diagnostic criteria for AAA?
> 50% of normal diameter
What imaging modalities are used for AAA?
AXR
US
who can participate in the screening programme for AAA?
men >65
