Aortic disease Flashcards
What makes up the aortic root
Left crus (left sinus of Valsalva and left coronary ostium) Non-coronary crus Right crus (right sinus of Valsalva and right coronary ostium)
Three layers of the aorta
Tunica intima
Tunica media
Tunica adventia
3 risks of atherosclerosis
Stroke
MI
Aneurysm
Aneurysm definition
A localised enlargement of an artery caused by a weakening of the vessel wall
Describe a true aneurysm
Weakness and dilation of wall
involves all three layers
What is a true aneurysm associated with
Hypertension Atherosclerosis Smoking Collagen abnormalities Trauma Infection
Two types of true aneurysm
Saccular
Fusiform
Describe a false aneurysm
Rupture of wall of aorta with the haematoma either contained by the thin adventitial layer or surrounding soft tissue
Causes of false aneurysm
Inflammation
Trauma
Iatrogenic
Signs of false aneurysm
Thrill
Bruit
Pulsatile mass
Signs and symptoms of thoracic aneurysm
Asymptomatic SOB Heart failure Dysphagia (difficulty swallowing) Hoarseness Sharp chest pain radiating to back between shoulder blades (dissection??) Pulsatile mass Hypotension
What is an aortic dissection?
Tear (longitudal) in the inner wall of aorta, blood forces walls apart.
What is a type A and type B aneurysm by Stanford classification?
Type A - involving ascending aorta
Type B - not involving ascending aorta
What causes an aortic dissection
hypertension
atherosclerosis
trauma
Marfan’s syndrome
Histology of aortic dissection
cystic medial necrosis
What kind of valvular disease can dilation of ascending aorta cause?
aortic regurgitation
Symptoms of aortic dissection
Tearing, severe chest pain (radiating to back)
Collapse (tamponade)
Signs of aortic dissection
Reduced or absent peripheral pulses BP mismatch between sides Hypotension/hypertension Soft early diastolic murmur Pulmonary oedema Widened mediastinum
Investigations for aortic dissection
Chest x-ray
Echo
CT
Treatment for Type A aneurysm
Surgery
Treatment for type B aneurysm
Meticulous blood pressure control
Sodium nitriprusside + beta blocker
Infection that can cause aortic disease
Syphyllis
Inflmmation that can cause aortic disease
Takayasu’s Arteritis
3 causes of congenital aortic aneurysm
Biscuspid aortic valve
Marfan’s syndrome
Coarctation
3 shunts of coarctation
Ductus arteriosus
Foramen ovale
Ductus venosus
3 types of coarctation
Pre-ductal
Ductal
Post-ductal
Signs of coarctation
Cold legs
Poor leg pulses
Pulse delay if coarctaation before left subclavian artery
Radial - radial delay
RIGHT radial-femoral delay
Pulse delay if coarctation after left subclavian artery
Right and left radial-femoral delay
