Aneurysm (aortic + large arteries)

Question 1

Definition

Answer 1

Permanent localised dilation/ swelling of an artery (An abnormal bulge in the aorta)

Question 2

Aetiology/ causes

Answer 2

Idiopathic cause but there are many predisposing/ risk factors

Question 3

Risk factors

Answer 3

Family history can increase risk
Atherosclerosis (hardened arteries)

Having a bicuspid aortic valve instead of three valves since birth.

Connective tissue disorders such as Marfan syndrome and Ehlers-Danlos syndrome

Infections such as syphilis or salmonella

Smoking

Question 4

Epidemiology/ Population affected

Answer 4

Common in ages 60+
White race/ males

Question 5

Clinical presentation

Answer 5

Can be asymptomatic

Symptoms can be caused by pressure effects or vessel

Typically an abrupt onset of severe, tearing, central chest pain, radiating through to the back + tenderness

Involvement of the branch arteries may produce neurological signs, absent pulses, and an unequal BP in the arms

Cough or hoarseness
Shortness of breath
Pain in the back, jaw or neck

Question 6

Prognosis

Answer 6

Weakness of the aortic wall through increased dilation tends to increase over time, further increasing the risk of rupture (aortic dissection/ rupture)

Question 7

DDX

Answer 7

Mesenteric ischemia
Peptic ulcer disease
Diverticulitis
Pyelonephritis
Myocardial infarction
Ureteric colic