Aneurysms Flashcards
what is a localized dilation of a blood vessel or chamber of the heart?
aneurysm or dissection
what are the most common sites of aneurysms in order from greatest to least common?
- aorta
- iliac
- splenic
- renal
- vertebral
what are the two categories of aneurysms?
true and false
what is a true aneurysm?
where the aneurysm is bounded by arterial wall components (all 3 layers dilate)
what is a false aneurysm?
where a breach in the wall leads to a vascular hematoma (through internal layers -> bleed into tunica media/adventitia)
what is the most common etiology of TRUE aneurysms?
atherosclerotic
what are 4 common etiologies of true aneurysms
atherosclerotic (MC)
syphilitic (Treponema pallidum)
congenital
left ventricular (dilative cardiomyopathy)
where do syphilitic aneurysms tend to localize?
around ascending aorta
what is the most common cause of FALSE aneurysms?
post myocardial infarctive
what are the 3 causes of FALSE aneurysms?
- (MC) post myocardial infarctive
- junctional leak at vascular graft
- genetic
what does junctional leak at a vascular graft mean?
tearing of stitches or bleeding within new vessel during or after cardiac bypass surgery
what are the 2 genetic collagen vascular disease that can lead to genetic FALSE aneurysms?
Marfan’s syndrome
Ehler’s Danlos syndrome
what is Marfan’s syndrome?
it is a defect in fibrillin in which causes a person to be long, tall, and thin
what is Ehler’s Danlos syndrome?
very compliant collagen = very stretchy/flexible people
what kind of aneurysm is very small spherical dilations (blueberry size)?
Berry aneurysm
(Rarely greater than 1-1.5 cm)
where do berry aneurysms most frequently occur at?
at the brain base (circle of Willis)
is a berry aneurysm TRUE OR FALSE?
TRUE
what kind of aneurysm is large spherical dilations (5-10 cm)?
saccular
(same as berry but bigger)
are saccular aneurysms true or false?
TRUE
what kind of aneurysm is gradual and progressive dilation of a blood vessel producing a spindle shaped expansion?
fusiform
T/F: fusiform aneurysms may be eccentric (dilation may occur unilaterally)
T
are fusiform aneurysms true or false?
TRUE
what kind of aneurysm refers to escape of blood into the tunica media?
dissecting aneurysm
what is the presentation of the lumen of a dissecting aneurysm?
double barrel presentation
T/F: you need dilation of the blood vessels for a dissecting aneurysm to occur
F
what are the 2 different types of dissecting aneurysms and how are they different?
Type A- includes the ascending aorta
Type B- does not include the ascending aorta
is a dissecting aneurysm TRUE or FALSE?
false
what kind of aneurysm is caused by traumatic injury to muscle layer producing a focal dilation?
pseudoaneurysm (traumatic aneurysm)
you can classify an aneurysm by which two ways?
etiology or location
name 5 classifications of aneurysms based on etiology or location
- atherosclerosis
- infection
- syphilis
- arteritis (kawasaki disease)
- miscellaneous
what is the most common area for a atherosclerotic aneurysm?
in the abdominal aorta
atherosclerotic aneurysms are most common in what population?
males around 60-80 years old
when is an atherosclerotic aneurysm usually diagnosed?
when it is greater than 50% dilation of normal diameter of vessel has occurred
what 2 things are atherosclerotic aneurysms usually associated with?
hypertension (40%) and heart disease (30%)
where does pain manifest when you have an atherosclerotic aneurysm?
intermittent back and abdominal pain
what are some other symptoms of atherosclerotic aneurysms?
claudication and lower limb ischemia
what is the difference between neurogenic and vascular claudication?
- neurogenic claudication: limb doesn’t work well all the time
- vascular claudication: can walk a bit, then it is hard
how are atherosclerotic aneurysms commonly found?
accidental discovery is extremely common when plain film, MRI, CT is taken for back pain evaluation
aneurysms less than 5cm have __________ chance of rupture
5%
aneurysms greater than 6cm have _____ chance of rupture
15%
aneurysms greater than 7 cm have _____ chance of rupture
75%
T/F: treatment must take into account the risk/benefit of surgical intervention
T
what does treatment for atherosclerotic aneurysms consist of?
removal of dilation and replacement with graft
