Aneurysm Flashcards
Aneurysm, what is it
- an abnormal dilations in the blood vessels
- occurs in any arteries: aorta, femoral, iliac, popliteal, cerebral, and sometimes veins, but way less common due to low pressure system
List the Different categories of aneurysm
- True aneurysm: all layers of the blood vessels are dilated, subdivided into
.Fusiform aneurysm -> true aneurysm balloting out symmetrically
.Saccular (berry) aneurysm -> asymmetrical aneurysm: balloting only on one side (one side weaker) - Pseudoaneurysms: false aneurysms
Caused by a small whole in the vessel -> causing the blood to leak out and form something that looks like a berry or fusiform aneurysm
Aortic aneurysm: locations
- Aorta most commonly
- Abdominal aorta (60%), below the renal artery and above the aortic bifurcation (due to less elastin -> weaker)
- Thoracic aorta (40%)
Aortic aneurysm: C
- due to a weakness in the blood vessel wall
Aortic aneurysm: E
1) HTN
If HTN occurs in the vasavasorum -> development of hyaline arteriosclerosis -> causing narrowing of their lumen -> causing ischemia to the aortic wall -> weakening of the aortic wall
2) Atherosclerosis
Mostly seen in the abdominal aorta
3) Tertiary syphilis
causes inflammation in the tunica intima of the vasa vasorum -> narrowed lumen -> restricted blood flow to the aortic aorta
4) Bacterial infections
Called mycotic aneurysms: emboli bacterias go to intracranial arteries, visceral arteries or arteries feeding arms and legs -> weakens vessel walls -> aneurysm
5) Genetic disorders
.Marfan syndrome
.Ehler’s danlos syndrome
.Cystic medial degeneration
Aortic aneurysm: Complications
- intact aneurysms: no symptoms, unless in compresses organs/vessels around it -> Inf/Sup vena cava -> decreased venous return to the heart
- Rupture: causing ischemia to the downwards tissues
- aortic insufficiency: if the thoracic aneurysms is right above the aortic valve -> pulls aortic valves away -> preventing it from closing
- Subarachnoid bleeding: causing pressure in brain tissue -> causing irritation of the meninges -> intense headache + inability to flex the neck forward
- Blood clot formation
Aortic aneurysm: signs and symptoms
- Abdominal aortic aneurysms: severe pain in the left flank, pulsatile mass, hypotension (classic sign of abdominal aortic aneurysms)
- thoracic aortic aneurysms: usually no symptoms, severe back and abdominal pain,
Aortic aneurysm: diagnosis
- imaging
- US, CT, MRI
- aortography is the preferred diagnostic modality for the evaluation of thoracic aortic aneurysm, although tranesophageal echocardiography and computed tomography scanning are often used before this
Aortic aneurysm: T
- surgery
Charcot Bouchard micro aneurysms:
- type of central nervous system aneurysm associated with chronic HTN and commonly affects the small vessels of the deep brain