Aneurysms Flashcards
Describe the difference between various types of aneurysms.
What is Berry Aneurysm?
True Aneurysm
Small circle dilation of the vessel found in the circle of Willis in the brain
Describe the difference between various types of aneurysms.
What is Fusiform Aneurysm?
True Aneurysm
Blood vessel widens on all sides and characterized by a gradual and progressive dilation of the vessel
Describe the difference between various types of aneurysms.
What is Saccular Aneurysm?
True aneurysm
Small sac or pouch sticking out from a blood vessel.
Describe the difference between various types of aneurysms.
What is Dissecting Aneurysm?
If dissection occurs in aorta?
False aneurysm
Inner layer of a blood vessel tears, causing blood to flow between the layers of the vessel wall and slows down/ blocks blood flow
It can be life threatning
What is the most common cause of Aneurysms?
What is the main concern with aneuryms?
Hypertension
It may rupture if left untreated. Do not let it rupture!!!!!!!
Signs and Symptoms of Aneurysms depend on?
Aneurysm may also be?
With first symptom being
Size and location
Asymptomatic, with the first evidence of its presence being associated with vessel rupture
Thoracic Aorta Aneurysm Clinical Manifestations
4 and why?
May also have?
Dyspnea, stridor, or brassy cough.
Why: Pressure on the trachea.
Hoarseness
Why: Pressure on the laryngeal nerve
Difficulty swallowing
Why: Pressure on the esophagus.
Distention of neck veins and edema of the face/neck.
Why: Compression of the superior vena cava
May also have substernal, back, and neck pain
Abdominal Aorta Aneurysm
Clinical Manifestations
First sign?
May experience?
Pulsating mass!!!!
May experience abdominal or back pain and may move to back of legs.
Identify the clinical manifestations associated with a ruptured aneurysm.
The larger the aneursym, the more risk of it rupturing.
Explain the conservative medical therapy associated with a small, asymptomatic aneurysm.
Risk factor modification like?
Growth rates may be lowered with?
Patients with <4.0 are monitered?
stop tobacco use
decreasing BP
optimizing lipid profile
gradual increase in activity.
Growth rates may be lowered with beta blockers, ACE inhibitors, ARBs, and statins
Patients with aneurysms less than 4.0 are monitered by ultrasound every 2-3 years or often
X-ray?
ECG?
Ultrasound?
CT?
What question would you ask a patient before
they have a diagnostic test using contrast?
X-rays reveal abnormal widening of the aorta.
ECG may be done to determine if there are any changes with electrical conduction or ischemia.
Ultrasound can monitor aneurysm size
A CT scan is the most accurate diagnostic test to determine the length and cross-sectional diameter and presence of a thrombus
Do you have kidney disease? Contrast is nephrotoxic
Describe an open aneurysm repair (OAR)
What are potential complications?
Cuts into the diseased aortic segment and removes any thrombus or plaque
Sutures a synthetic graft to the aorta proximal and distal to the aneurysm
Sutures the aortic wall around the graft to act as a protective cover
Infection and bleeding
Describe an endovascular aneurysm repair (EVAR)
How would you explain this to a patient?
Less invasive and an alternative to OAR
Placement of a suture-less aortic graft into the aorta and the aneurysm via the femoral artery.
Insertion of a graft covered by a tubular metal web stent
Stent graft is slowly released into the blood vessel and expands in size
What would a patient say (or do) that would indicate they are experiencing an aortic dissection?
What happens in Early stages of dissection?
With progression?
Abrupt presence of excruciating pain, described as tearing or ripping
Early Stages: BP is elavated
With progression: BP and the pulse become unobtainable in one or both arms as the dissection disrupts arterial flow to the arms
Two important factors that can worsen the aortic dissection are?
Elevated BP and steepness of the pulse wave
Explain the treatment associated with an aortic dissection.
Focuses on control of Hypertension and drugs that decrease the force of systolic blood ejection from heart.
Surgical options are cutting the infected part and replacing it with a graft (resection)
