Aortic Disease 1

Question 1

Describe the sections of the thoracicorta as mentioned in the lecture.

Answer 1

The sections are aortic root, ascending aorta, aortic arch, and descending thoracic aorta.

Question 2

Define the sinus of Valsalva and its significance in the aortic root.

Answer 2

The sinus of Valsalva is a dilation in the aortic root where the coronary arteries originate.

Question 3

How is the aortic root typically measured in clinical practice?

Answer 3

The aortic root is measured at three levels: annulus diameter, sinus of Valsalva diameter, and sinotubular junction diameter.

Question 4

Do you know the layers that make up the wall of the aorta?

Answer 4

The layers are intima (innermost), media (middle), and adventitia (outermost).

Question 5

Describe the histology of the intima in the aorta.

Answer 5

The intima consists of endothelial cells and sub-endothelial collagen and elastic fibers.

Question 6

What is the significance of the sinotubular junction in the aortic anatomy?

Answer 6

The sinotubular junction is the connection point between the sinus of Valsalva and the ascending aorta, crucial for structural integrity.

Question 7

Describe the layers of the wall of the aorta.

Answer 7

The layers are intima, media, and adventitia.

Question 8

What is atherosclerosis and its significance?

Answer 8

Atherosclerosis is the commonest cause of death in the western world, characterized by the buildup of plaque in arteries.

Question 9

Define an aneurysm.

Answer 9

An aneurysm is a localized enlargement of an artery caused by a weakening of the vessel wall.

Question 10

How does a true aneurysm differ from a false aneurysm?

Answer 10

A true aneurysm involves all three layers of the artery wall, while a false aneurysm is caused by a rupture in the wall.

Question 11

Describe some risk factors for atherosclerosis.

Answer 11

Risk factors include hypertension, hypercholesterolemia, smoking, diabetes, and family history.

Question 12

What are some conditions that can predispose to thoracic aortic aneurysms?

Answer 12

Conditions include hypertension, atherosclerosis, smoking, bicuspid aortic valve, Marfan’s syndrome, and syphilis.

Question 13

Describe the difference between a true aneurysm and a pseudoaneurysm in terms of their arterial wall composition.

Answer 13

A true aneurysm is made of all three layers of the artery wall while a pseudoaneysm may only of surrounding structures or thin layer of advent.

Question 14

Describe the difference between a normal aortic aneurysm and aortic dissection.

Answer 14

Aortic dissection is caused by a tear the inner wall of aorta, leading blood entering and splitting the wall, while an aneurysm involves a localized dilation of the aorta.

Question 15

Define false lumen in the context of aortic dissection.

Answer 15

False lumen is the new channel created by blood entering through the wall of the aorta during a dissection, potentially leading to complications like occlusion of side branches.

Question 16

How can aortic dissection lead to organ ischemia?

Answer 16

Aortic dissection can lead to organ ischemia by potentially occluding side branches of the aorta, including coronary, mesenteric, carotid, renal, and spinal arteries.

Question 17

Describe the histological findings in the aorta of a patient with aortic dissection.

Answer 17

Histologically, aortic dissection may show cystic media necrosis, characterized by muco-polysaccharide cysts replacing smooth muscles and elastin in the media layer.

Question 18

What are some risk factors for aortic dissection?

Answer 18

Risk factors for aortic dissection include hypertension, atherosclerosis, Marfan syndrome, bicuspid aortic valve, and trauma.

Question 19

How can aortic dissection present clinically if it involves the coronary arteries?

Answer 19

Aortic dissection involving the coronary arteries may present as acute myocardial infarction due to compromised blood flow to the heart muscle.

Question 20

Describe the Stanford classification for aortic dissection.

Answer 20

It categorizes dissections as Type A (involving ascending aorta) or Type B (not involving ascending aorta).

Question 21

What are common symptoms of acute thoracic aortic dissection?

Answer 21

Severe chest pain, collapse, stroke symptoms, reduced peripheral pulses, hypertension or hypotension.

Question 22

Define the test of choice for diagnosing thoracic aortic dissection.

Answer 22

C.T. angiogram aorta is the preferred diagnostic test.

Question 23

How does the Stanford classification differentiate between Type A and Type B dissections?

Answer 23

Type A involves the ascending aorta, while Type B does not.

Question 24

Describe the limitations of a transthoracic echocardiogram in diagnosing aortic dissection.

Answer 24

It can only confidently visualize the aortic root and proximal ascending aorta, potentially missing dissections in other areas.

Question 25

What is the mortality rate associated with aortic dissection?

Answer 25

Approximately half of patients die before reaching the hospital, and mortality remains high even for those who receive treatment.

Question 26

Describe the findings in a chest X-ray of a patient with dissecting aortic aneurysm.

Answer 26

Widened mediastinum and a dissection flap.

Question 27

What is the test of choice for diagnosing aortic dissection?

Answer 27

CT angiogram aorta.

Question 28

How is a Type A aortic dissection managed?

Answer 28

It is a surgical emergency requiring blood pressure control, IV beta blockers, nitrates, and potential surgery.

Question 29

Define Type B aortic dissection.

Answer 29

A dissection that does not involve the ascending aorta and is typically managed medically with blood pressure control.

Question 30

Do all Type B aortic dissections require surgical intervention?

Answer 30

No, they are usually managed conservatively with blood pressure control, but intervention may be considered in certain situations.

Question 31

What are the main treatments for Type B aortic dissection?

Answer 31

Controlling blood pressure and considering endovascular or surgical intervention in specific cases.