Aneurysm

Question 1

Complication of thoracic aneurysm

Answer 1

Stretch aortic valve = aortic insufficiency

Compress mediast. structures - airway/oesophagus

Lose laminar flow – > activate coag cascade -> thrombosis

Question 2

What is aortic dissection?

2 things needed for aortic dissection?

Answer 2

Longitudinal tear @ lumen ->
blood go through INTIMA -> ripped through MEDIA

1. Lots of pressure to rip through media
2. Pre-existing weak media!!!!!

Question 3

Why does the prox 10 cm of the aorta have vasa vasorum in adventitia?

Explain how HTN causes dissection.

Answer 3

Proximal 10 cm of aorta = thick -> diffusion of oxygen across wall not sufficient enough – >

Have adventitia with the VASA VASORUM

HTN –> hyaline arteriolosclerosis of vasa vasorum
-> ⬇️lumen calibre -> ⬇️BF to outer half of wall = ATROPHY

Question 4

Causes of aortic dissection

Answer 4

Pregnancy, Coarctation, HTN, EhlorsDanlos, Marfans
-> dissect media –>

AV regurg + sharp tearing chest pain radiate to back ->

RUPTURE INTO MEDIASTINUM,
OBSTRUCT, TAMPONADE

Question 5

What causes the thoracic aneurysms

Answer 5

Marfan’s @ YOUNG
HTN -> cystic medial degeneration @ OLD
Tertiary syphilis obliterative endarteritis of vasa vasorum = ⬇️️blood flow

–> BV wall atrophy -> weak wall