Aortic aneurysm Flashcards
What is an aneurysm
Anneurysm is a permanent localised dilation of an artery
Aneurysms are often asymptomatic, how do they causes symptoms?
cause symptoms by pressure effects or vessel rupture
Where do aortic aneurysms most commonly occur?
Abdomen
Describe the pathology of an uncultured aortic aneurysm
Result from degenerative process
Some are due to connective tissue diseases
Present in elderly men
How are abdominal aortic aneurysms usually diagnosed?
Found as a pulsating mass on an abdo exam
Or as calcification on a plain Xray
What are the symptoms of a non ruptured abdominal aortic aneurysm?
Symptoms due to pressure effects- epigastric or back pain
An abdominal aortic aneurysm ruptures:
Surgical emergency. How will the patient present?
Presents with epigastric pain radiating to back + hypovolaemic shock.
How is a ruptured abdominal aortic aneurysm diagnosed?
USS or CT scan
How is a ruptured aortic anneurysm managed?
Urgent control of BP using hypotensives to keep systolic at 100-110mmHg (lanetalol and esmolol IV)
Surgical replacement of the aneurysmal section with prosthetic graft – if symptomatic/large asymptomatic
Endovascular repair with insertion of stent – if surgery not possible
What are the usual causes of thoracic aorta
Cystic medial necrosis and atherosclerosis are the usual causes
How does an unruptured thoracic aneurysm present?
Asymptomatic or pressure on local structures (back pain, dysphagia and cough) or aortic regurgitation if the root is involved
How does a dissecting aortic anneurysm occur
Aortic dissection results from a tear in the intima.
Blood under high pressure creates a false lumen in the diseased media.
How does a dissecting aortic aneurysm occur?
Abrupt onset of severe tearing central chest pain radiating to the back.
Involvement of branch arteries may produce neurological signs, absent pulses and unequal pulses in arms.
How does a dissecting aortic aneurysm diagnosed?
CXR- widened mediastinum
Confirm diagnosis with CT, Transoesophageal echo, or MRI
