Acute Aortic Dissection / Aneruysm Flashcards
What layer of the aorta stretches during high BP?
Medial layer of the muscle - can stretch a long way
What layer of the aorta does not stretch very far during high BP?
Intimal layer
what happens when the medial layer grows and the intimal layer doesn’t?
A TEAR - Dissect the two layers
False lumen of blood between medial and intimal
Clinical signs of aortic aneurysm
Severe “tearing, ripping”
Radiates to back, flank, shoulder
What is the BP in aortic anerusym
Difference of more than 20 when comparing BP in both arms + leg
Why do you have Hypotension?
Blood is in the buldge and can’t get around to the rest of the body
If the tear is really high -
Blood is blocked from one arm
Ascending dissection
Carotids won’t have sufficient blood flow
Most deadly - Most common
Descending dissection
Renal arteries negatively affected
Branches to spinal cord
Femoral pulses less due to blood being blocked from the body
Ascending dissection problems
Stroke like s/s Altered LOC Cardiac tamponade MI Acute aortic insufficiency
Descending dissection problems
Anuria / Renal Failure
Paraplegia
Loss of distal pulses
Aortic Aneurysm problems
CP - Coronary blood flow compromised
Dysphagia - Pressing esophagus
Wheezing - Pressing Trachea
Hoarseness - Pressing on left recurrent laryngeal nerve
Aortic Emergencies TX
2 Large Bore
Type and Cross for 6 U PRBCs
Morphine
Surgical
Aortic Pressure Goals for Tx
HR 60-80
SBP 100-120
Aortic Pharmacology Tx
BB
Nitroprusside
CCB
