aneurysms and dissections & pertinent disorders/risk factors

Question 1

aneurysm

Answer 1

localized dilation of an artery or heart chamber due to wall weakness.

Question 2

aneurysm causes

Answer 2

• atherosclerosis
• HTN
• local infection (mycotic aneurysm, syphilic aneurysm
• congenital defect
• trauma

Question 3

AAA

Answer 3

Usually occur below renal arteries

Grow a few mm/year (slowly)

Question 4

AAA risk factors

Answer 4

Male, >50, smoker, with atherosclerosis

Question 5

AAA 2 outcomes:

Answer 5

1. rupture = death
2. (more common) thrombi on internal wall (mural thrombi) which may embolize into the arteries of the legs or intestines leading to ischemia or gangrene

Question 6

thoracic aortic aneurysms

Answer 6

Associated w HTN and late syphilis. Patients with small ones can safely be followed by regular imaging
Tx: surgical replacement by prothesis, but mortality risk is 5%

Question 7

vascular dissection

Answer 7

longitudinal tearing within the wall of the artery, caused by blood that enters the wall through a defect in the lining, usually an ulceration in an atheroma. Blood pulses into the wall and progresses (dissects) along tissue planes in the wall until it re-enters the main channel (rare) or ruptures

Question 8

risk factors for vascular dissection

Answer 8

older men w HTN

in young men, Marfan syndrome or ehlers-danlos syndrome, both weaken the lining of the aortic wall

Question 9

vascular dissection s/s

Answer 9

severe chest and back pain
neurological symptoms +
difference in BP in the right and left arms (bc of occlusion of one of the great vessels)
Emergency surgery is necessary