Aoritc Disease

Question 1

What is the difference between a true and pseudoaneurysm?

Answer 1

True: dilation of all 3 layers of the aorta wall

Pseudo: contained rupture of the aorta wall. The intima and media layers tear allowing blood to leak out from the lumen. The only thing holding it in is the adventitia layer.

Question 2

Main cause of true aortic aneurysms.

Answer 2

Atherosclerosis

Question 3

What is a cause of degenerative changes in the media layer of the aortic wall that can lead to a true aneurysm?

Answer 3

Cystic Medial Degeneration

ex. Marfan Syndrome

Question 4

What measurement is used to assess the risk of aneurysm rupture?

Answer 4

Diameter

5cm means 20-40% chance

Question 5

What aortic aneurysm diameter measurement increases the risk of rupture in a patient with Marfan Syndrome?

Answer 5

> 4.5 cm

Question 6

What are the two classifications of aortic dissection?

Answer 6

Type A: includes ascending aorta

Type B: does not include ascending aorta

Question 7

Presentation and treatment for each type of aortic dissection.

Answer 7

Type A: ripping or tearing chest pain that may accompany pain between the scapulae
Tx: beta blocker + sodium nitroprusside –> surgery

Type B: ripping or tearing pain between the scapulae
Tx: medical management to reduce BP

Question 8

What is the pathology of a penetrating aortic ulcer?

Answer 8

Atherosclerotic lesions penetrate the internal elastic layer creating an intramural hematoma. Most commonly occurs in descending aorta.

Question 9

What is Tx for penetrating aortic ulcer?

Answer 9

1. BP control

2. Endograft