Aortic Disease Flashcards
What are risk factors of aortic dissection?
HTN
Marfans
Ehlers Danlos
Turners/Noonan
Syphillis
What are clinical features of dissection?
Tearing chest pain radiating to the back
- chest more common in type A
- back more common in type B
Aortic regurg- early diastolic murmur
Absent pulses
Hypertension
What is the classification of dissection?
Stanford
Type A- ascending aorta affected
Type B- Descending aorta
Diagnosed by CT angio
CXR- may show widened mediastinum
What is the management of dissection?
Type A
- surgical management
- permissive hypotension- target systolic 100-120mmHg
Type B
- Medical management
- Labetalol to reduce BP
What are complications of dissection?
Backward tear
- aortic incompetence/regurg
- MI
Forward tear
- Unequal pulses
- stroke
- renal failure
What conditions are associated with coarctation of the aorta?
Turners Bicuspid Aortic Valce
What are features of coarctation?
Infancy
- HF
- failure to thrive
- absent femoral pulses (radio-femoral delay
Adult
- uncontrolled HTN
May have systolic murmur or apical click
What investigations are required for coarctation?
CXR- Notching of inferior border or ribs Roesler sign
What are risk factors for aortic aneurysm?
Smoking
HTN
Connective tissue disorder
Family history
More common in males
What are clinical features of AA?
Abdo pain radiating to back
Asymptomatic until rupture
Palpable pulsatile mass in abdo
Signs of shock if ruptured
Bruits over aneurysm
What is the screening program for AAA?
Men >65 can ask for one off scan
<3cm= normal
3-4.4cm= yearl scan
4.5-5.4cm= 3 monthly scan
>5.5cm or >1cm/yr/symptomatic need 2 ww referral for surgical correction
What investigations are required for AAA rupture?
Bedside USS can diagnose
CT angio=gold standard
Group and Save/Crossmatch
Bloods
