Aortic aneurysm Flashcards
What is an aortic aneurysm?
An aortic aneurysm is an enlargement of the aorta to greater than 1.5 times normal size
They usually cause no symptoms except when ruptured
What is the most common anatomical location for an aortic aneurysm?
They are most commonly located in the abdominal aorta, but can also be located in the thoracic aorta
What are the signs and symptoms of abdominal aneurysms?
Most intact aortic aneurysms do not produce symptoms.
As they enlarge, symptoms such as abdominal pain and back pain may develop. Compression of nerve roots may cause leg pain or numbness
Bruits
What are true aneurysms?
Involve all three layers:
- Tunica intimia
- Tunica media
- Tunica adventitia
What is the average age of diagnosis for an abdominal aortic aneurysm?
65-70
What does the risk of aneurysm rupture relate to?
The diameter
Once the aneurysm reaches about 5 cm, the yearly risk of rupture may exceed the risks of surgical repair for an average-risk patient
What are symptoms of a ruptured aortic aneurysm?
Abdominal pain which is:
- Severe
- Constant
- Radiates to the back
What are risk factors for developing aortic aneurysm?
Alcohol
Tobacco
Coronary artery disease
Atherosclerosis
What is the pathophysiology of aortic aneurysms?
Most commonly due to an intrinsic abnormality in the elastin and collagen components of the aortic wall
How would you diagnose an aortic aneurysm?
The diagnosis of an abdominal aortic aneurysm can be confirmed at the bedside by the use of ultrasound. Rupture may be indicated by the presence of free fluid in the abdomen
A contrast-enhanced abdominal CT scan is the best test to diagnose an AAA and guide treatment options
How would you manage an aortic aneurysm?
Consider aneurysm repair for people with an unruptured abdominal aortic aneurysm (AAA), if it is:
- symptomatic
- asymptomatic, larger than 4.0 cm and has grown by more than 1 cm in 1 year (measured inner-to-inner maximum anterior-posterior aortic diameter on ultrasound)
- asymptomatic and 5.5 cm or larger (measured inner-to-inner maximum anterior-posterior aortic diameter on ultrasound).
What is aortic dissection?
Aortic dissection (AD) occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart
What are the symptoms of aortic dissection?
In most cases, this is associated with a sudden onset of severe chest or back pain, often described as “tearing” in character
Also, vomiting, sweating, and lightheadedness may occur
What are risk factors for aortic dissection?
High blood pressure, Marfan syndrome, Turner syndrome, bicuspid aortic valve, previous heart surgery, major trauma, smoking
What causes aortic dissection?
Hypertension and it is associated with connective tissue disorders
