ANEURYSMS Flashcards
ABDOMINAL AORTIC ANUERYSM SX?
+ INTERSCAPULAR PAIN
THORACIC AORTIC ANEURYSM SX?
-CP RADIATING TO BACK
- ACUTE AR MURMUR–DECRECENDO MURMUR OR EARLY DIASTOLIC MURMUR AT THE RSB
- WIDENED MEDIASTINUM+
SRGICAL REPAIR GUIDELINES IN THORACIC VS ABDOMINAL ANURYSMS
**NO SYMPTOMS
AND
+ THORACIC ANURYSM>6MC
***SURGERY WHEN >6CM
**NO SYMPTOMS
AND
+ ABDOMINAL ANURYSM>5.5CM
***SURGERY WHEN >5.5CM
+ SX
DO SURGERY AT ANY SIZE IF +SX IN BOTH THORACIC AND ABDOMINAL ANERYSMS!!
AAA SCREENING GUIDELINES?
ANY MALE BTW 65-75 WHO EVER SMOKED GET AT LEAST 1X US TO SCREEN FOR AAA
PT WITH + SCREEN FOR AAA AND + TOBACCO HISTORY
AGE 65-75 NEXT STEP WITH + ANEURYSM?
DEPENDS ON THE SIZE
3-3.9===US Q3YRS
4-4.9=== US Q1 YEAR
5-5.4===IS Q6 MONTHS
>5.5====SURGERY NOW
PT WITH SEVERE CP RADIATING TO BACK AND BP190/100
+DEC MURMUR
MOST LIKELY DX?
BEST TEST TO DX?
NEXT STEP AFTER +DXIC TEST FOR DX?
MOST LIKELY: AORTIC DISSECTION
BEST TEST–TEE
NEXT STEP—
#1TOC–BB TO DECREASE BP
IF BP REMAINS HIGH DESPITE BB THEN 2ND LINE TO ADD—-IV NITRO
NEVER GIVE IV NITRO BEFORE BB IN THESE PTS— IT CAUSES REFLEX TACHYCARDIA AND WORSENS THE DISSECTION IF GIVEN BEFORE BB
SEVERE CP RAD TO BACK
BP 80/60
+JVP WITH +RAPID X WAVE
PUPILS+ CONSTRICTION
CLEAR LUNGS
HEART SOUNDS MUFFLED
+SM RADIATINGS TO CAROTID @RSB AND
+SM HEARD IN INTERSCAPULAR AREA
EKG-LOW VOLT+
MOST LIKELY DX?
CARDIAC TAMPONADE WITH BLOOD IN PERICARDIAL SAC DUE TO AORTIC DISSECTION!!
