Abdominal aortic aneurysm (AAA) Flashcards
1
Q
What is the definition of a AAA?
A
Permanent localised dilatation of the aorta
Vessel diameter >3 cm
2
Q
How common is a AAA?
A
Prevalence in the UK of 1.3-12.7% in the UK
3
Q
What is the pathology of an AAA?
A
- Most arise from below the level of the renal arteries
- Mostly caused by a degenerative process
- Degradation of the elastic lamellae
- Enhanced proteolysis
- Smooth muscle cell loss
- Affects all 3 layers of the arterial wall
- Symptoms caused by pressure/rupture
- RUPTURE IS A MEDICAL EMERGANCY
4
Q
What are the risk factors/aetiology of AAA’s?
A
- Elderly
- Men – though the risk of rupture is greater in woman
- Atherosclerotic damage
- Family history
- Smoking
- Hypertension
- COPD
- Hyperlipidaemia
- Trauma
- Infection e.g. HIV, TB
- Inflammatory diseases
- Connective tissue disease
5
Q
What are the signs/symptoms of an AAA?
A
- Can be asymptomatic
- Epigastric/back/loin/groin pain
- Pulsating mass on abdominal examination
- Features of limb ischemia
- Abdominal bruit
- Grey Turner’s sign – retroperitoneal haemorrhage
- Rupture:
- Hypotension
- Abdominal symptoms
- Acute severe lumbar/abdomen/loin pain
- Syncope
- Shock
6
Q
What investigations are carried out for a suspected AAA?
A
- FBC, clotting screen, U&E’s, LFT
- Cross match
- ECG
- X ray
- Shows calcification
- US
- CT
7
Q
How does having an AAA affect a patients ability to drive?
A
May not drive if aneurysm is >6.5cm – may be relicensed after surgery
8
Q
What are the surgical treatments for an AAA?
A
- Surgical replacement with prosthetic graft – symptomatic aneurysms/large asymptomatic aneurysms
- Open repair
- Endovascular repair with insertion of aortic stent – for those that are poor surgical risk
9
Q
What are the pharmacological treatments for an AAA?
A
- Antihypertensives
* Statins
10
Q
What are the non pharmacological treatments for an AAA?
A
- Regular US monitoring
- Smoking cessation
- AAA screening above the age of 65
