Aortic conditions Flashcards
What is the definition of an unruptured AAA
> 3cm across
What causes AAA
Degeneration of elastic lamellae + smooth muscle loss
What are the RFs for AAA
smoking, HTN, syphilis, Ehlers Danlos type 1 and Marfans
What are the sx of AAA
often none
may have abdominal or back pain
What is the treatment of unruptured AAA
monitor w US and exam
elective surgery if 5cm or more
How does a ruptured AAA present
abdo pain radiating to the back, iliac fossa or groin
collapse
shock
expansive mass
What is the treatment of a ruptured AAA
VASCULAR SURGEON - EMERGENCY
What is aortic dissection
injury to the tunica intima (innermost) allowing blood to flow between the layers of the aortic wall, forcing the layers apart
What is the most important RF for aortic dissection? What are other RFs?
HTN
Increased BP - HTN, coarctation of aorta
Weakened walls - CTDs (marfans, EDT1, aneurysm)
What are the clinical features of aortic dissection? how might they vary?
- Severe sudden tearing chest pain +/- radiation to the back
- Aortic regurgitation
- HTN
Vary with which part of the aorta it affects:
Coronary arteries - angina
Spinal arteries - paraplegia
Distal aorta - limb ischaemia
Renal arteries - anuria
How can aortic dissection be classified?
Type A - ascending aorta (2/3)
Type B - descending, distal to left subclavian
also debakey classification
What is the treatment of aortic dissection
type A - surgery, target BP 100-120 systolic
type B - conservative, bed rest, reduce BP w IV labetalol
What are complications of aortic dissection
Pericardial tamponade - bleeding into pericardium - pleuritic chest pain
Bleeding into mediastinum - shock, collapse
Compression of arteries by false lumen, sx mentioned in other q
What are ix for aortic dissection?
Transoesophageal echo
CXR
CT angiography
