Abdominal Aortic Aneurysm (AAA) Flashcards
How common is AAA?
present in 5% of population over the age of 60.
Who does AAA affect?
5X more in males than females
What are the symptoms of a rapid expansion or rupture of AAA?
S - epigastric O - sudden C - severe , tearing R - radiates through to back A - nausea, vomiting, dizzy , sweaty T - persistent E - S - 10
What are the signs of a ruptured AAA?
- hypotension
- tachycardia
- Anaemia
PULSATILE and EXPANILE ABDO MASS
What are the causes and risk factors of AAA?
1) Atherosclerosis (smoking, diabetes, hypertension, hyper-cholesterolaemia)
2) Infection (syphilis, E.coli, salmonella)
3) Genetic (marfan’s, Ehler’s-Danlos syndrome)
What invx are done to identify a suspected AAA?
USS
or
CT (more accurate)
How would you treat an immediate AAA rupture??
2 wide bore cannulas, Fluid bolus, ORh -ve blood, Hb crossmatch, VASCULAR SURGERY ASAP
What is the treatment for AAA?
1) Medical (control hypertension, stop smoking, statins, USS surveillance)
2) Surgery (graft, stent)
What is the mortality of elective surgery for AAA?
5%
What are the differentials for AAA?
(If severe pain radiating to back but no expansile mass)
- Pancreatitis
- renal colic
- testicular pain
What are the likely locations for a thoracic AA?
Ascending, arch or descending part of aorta
In what condition is it common to see a TAA in the ascending part of the aorta?
Marfan’s syndrome
In what condition is ti common to see a TAA in the arch and descending aorta?
- atherosclerosis
- syphilis
What are the symptoms of a rapidly expanding TAA?
- chest pain
- radiating to upper back
- stridor due to compressed bronchial teww
- haemoptysis (aortobronchial fistula)
- hoarse voice (compression of recurrent laryngeal nerve)
What is an aortic dissection?
a tear in the inside of the aorta causes blood to flow between the layers of the wall of the aorta, forcing the layers apart
