Aortic aneurysm and dissection Flashcards
whats an aneurysm?
artery with dilatation >50% of its original diameter
aneurysm path-physio
atherosclerosis, weakening of tunica media
common sites of aneurysm
aorta, iliac, femoral and popliteal arteries
complications of aneurysm
rupture, thrombosis, embolism, pressure on other structures
symptoms ruptured aneurysm
severe pain - epigastric radiating to the back
cariogenic shock - hypotension, tachycardia, sudden death
expandable abd mass
Tx for unruptured aneurysm
no intervention if
RF for rupture of aneurysm
BP high, smoker, female, FH
elective surgery for aneurysms
if >5.5cm or expanding at more than 1cm/yr
Stenting
Aortic dissection pathophysio
tear in intima, blood under pressure, enters tunica media dissecting along its length
(resulting in double barrelled aorta, rupture)
Aortic dissection cause
unknown
Rss: ageing, high BP, atherosclerosis, blunt trauma to the chest e.g. hitting steering wheel of car during accident
Presentation of dissection
sudden tearing pain radiating to the back
Ix for dissection
CT scan, transosophageal echocardiography (TOE)
cross march 10 units of blood!
Mx dissection
if ascending aorta involved - surgery
if it isn’t (30%), less clear.. HTN Mx?
