Aortic Aneurysm Flashcards
What is the pathology behind aortic aneurysm
3 LAYER DEGENRATION of vascular tunic
Ruptures due to HTN
Can lead to PTE
What are the risk factors for Aortic dissection
Marfan's and Ehlers Danlos Smoking HTN FHx Male >60 years
What is the presentation of aortic aneurysm
Asymptomatic = common
Pulsatile mass
Sudden epigastric pain to flank
Hypotension and Tachycardia
What is the vasa vasorum
It is a collection of vessels that supply the thick walls at the top of the aorta
Why is the top of the aorta susceptible to ischemia
HTN can cause hyaline atherosclerosis so lumen narrows.
The walls are thicker so have greater chance of ischemia here
What is the first line investigation for aortic aneurysm
Abdo Ultrasonograph
-Cheap Easy Sensitive Specific
How would you manage a RUPTURED aortic aneurysm
ABCDE w/ fluids and transfusion
AAA Graft surgery
How would you manage an aortic aneurysm
Manage RF
Regular imaging with Ultrasonography unless symptomatic
-Aymptomatic and <5.5cm = monitor
-Symptomatic and >5.5cm = EVAR
How would a patient with a ruptured aortic aneurysm present
Abdo pain Pulsatile mass Hypovolemic shock Syncope Nausea and Vomiting
Wha are some complications of AA
Rupture = hypotension
Thromboembolism = PVD
Fistula can form
What are the main causes of thoracic AA
Marfans/ED
Vasa Vasorum atherogenesis
How would you monitor a thoracic AA
CT/MRI
What is the main differential for Abdominal AA
Acute pancreatitis
- Non pulsatile
- Grey turner and Cullens sign
