Aortic aneurysm and dissection

Question 1

define aneurysm

Answer 1

full thickness dilatation of artery by more than 50%. (eg. aortic = normal 2cm, occurs when >3cm).

Question 2

Two types of aneurysm

Answer 2

True: dilatation of all layers in arterial wall
False: not all layers.

Saccular, fusiform, ruptured

Question 3

what is (surprisingly) not a risk factor for AA

Answer 3

diabetes

Question 4

screening for AA

Answer 4

65 years : abdominal aortic AA
if >3cm -> ongoing follow up
if >5.5cm - refer to surgical clinic for investigation

Question 5

4 common features of typical ruptured AAA

Answer 5

back pain
abdo pain
hypotension
collapse

Question 6

renal atypical presentation of ruptured AAA

Answer 6

left renal angle pain radiating to groin (‘first presentation of renal colic in man over 60)

Question 7

where is the pathology in aortic dissection

Answer 7

tear in intima (allows blood to enter into media of arterial wall -> propagates proximally and distally, dissecting layers of wall forming a channel

Question 8

Risk factors for aortic dissection

Answer 8

hypertension !!
marfan’s syndrome
65-75 years

Question 9

tearing chest pain most likely

Answer 9

type A dissection.

Question 10

cardiac complications of type A aortic dissection

Answer 10

acute mitral regurgitation
MI
cardiac tamponade
stroke

Question 11

sudden onset intrascapular pain more likely

Answer 11

type B dissection