Aortic Aneurysms & Dissections Flashcards
What is an Aneurysm?
How large should the abdominal aorta be?
up to 2.5cm in diameter
What pathological process activates protease & elactase?
Acute Inflammation
Could be due to trauma, ischemia, atherosclerosis, HTN, Smoking
Think things that damage the tunica intima
What is NAAASP?
The National Abdominal Aortic Aneursym Screening Programme.
Reviews people with increased risk factors; Age, Male, Marfans, Ehlers-Danlos
Oestrogen is thought to be protective for women
Where does the blood from a ruptured AAA go?
Infra renal - desceding aorta
AAA sits posterior behind perotineum (mesothelium) so blood in the abdominal cavity is called Retroperitneal bleeding
?Marfans
fibrilin
? Ehlers Danlos
collagen
Risk for AAA
Rupture
Why do you put >65yo men with AAA on antiplatelet despite risk of rupture?
Due to risk of other CVD
What is the MOA of a statin?
What is management of an AAA size 5-5.5cm?
watch & wait
What is management of an AAA larger than 6 cm
surgical referral with 2 week wait
What are the guidelines around AAA and driving?
Car drivers can continue if less than 6cm, must
notify the DVLA between 6-6.4cm and must
stop when equal to or more than 6.5cm
Bus/lorry drivers must notify the DVLA if
less than 5.5cm and must stop when equal to or more than 5.5cm
What is seen in pre-exisitng ischemia on an ECG?
Strain pattern
t wave inversion & st depression
EVAR vs Open repair
EVAR easier on patient
Via femoral artery with atherosclerosis
Open - increased risk of thrombus so MI/Stroke
increased risk of damage to renal vessels (& Mesenteric)
EVAR - endovascular repair
