Aortic disease

Question 1

What makes up the aortic root

Answer 1

Left crus (left sinus of Valsalva and left coronary ostium)
Non-coronary crus
Right crus (right sinus of Valsalva and right coronary ostium)

Question 2

Three layers of the aorta

Answer 2

Tunica intima
Tunica media
Tunica adventia

Question 3

3 risks of atherosclerosis

Answer 3

Stroke
MI
Aneurysm

Question 4

Aneurysm definition

Answer 4

A localised enlargement of an artery caused by a weakening of the vessel wall

Question 5

Describe a true aneurysm

Answer 5

Weakness and dilation of wall

involves all three layers

Question 6

What is a true aneurysm associated with

Answer 6

Hypertension
Atherosclerosis
Smoking
Collagen abnormalities
Trauma
Infection

Question 7

Two types of true aneurysm

Answer 7

Saccular

Fusiform

Question 8

Describe a false aneurysm

Answer 8

Rupture of wall of aorta with the haematoma either contained by the thin adventitial layer or surrounding soft tissue

Question 9

Causes of false aneurysm

Answer 9

Inflammation
Trauma
Iatrogenic

Question 10

Signs of false aneurysm

Answer 10

Thrill
Bruit
Pulsatile mass

Question 11

Signs and symptoms of thoracic aneurysm

Answer 11

Asymptomatic
SOB
Heart failure
Dysphagia (difficulty swallowing)
Hoarseness
Sharp chest pain radiating to back between shoulder blades (dissection??)
Pulsatile mass
Hypotension

Question 12

What is an aortic dissection?

Answer 12

Tear (longitudal) in the inner wall of aorta, blood forces walls apart.

Question 13

What is a type A and type B aneurysm by Stanford classification?

Answer 13

Type A - involving ascending aorta

Type B - not involving ascending aorta

Question 14

What causes an aortic dissection

Answer 14

hypertension
atherosclerosis
trauma
Marfan’s syndrome

Question 15

Histology of aortic dissection

Answer 15

cystic medial necrosis

Question 16

What kind of valvular disease can dilation of ascending aorta cause?

Answer 16

aortic regurgitation

Question 17

Symptoms of aortic dissection

Answer 17

Tearing, severe chest pain (radiating to back)

Collapse (tamponade)

Question 18

Signs of aortic dissection

Answer 18

Reduced or absent peripheral pulses 
BP mismatch between sides
Hypotension/hypertension
Soft early diastolic murmur
Pulmonary oedema
Widened mediastinum

Question 19

Investigations for aortic dissection

Answer 19

Chest x-ray
Echo
CT

Question 20

Treatment for Type A aneurysm

Answer 20

Surgery

Question 21

Treatment for type B aneurysm

Answer 21

Meticulous blood pressure control

Sodium nitriprusside + beta blocker

Question 22

Infection that can cause aortic disease

Answer 22

Syphyllis

Question 23

Inflmmation that can cause aortic disease

Answer 23

Takayasu’s Arteritis

Question 24

3 causes of congenital aortic aneurysm

Answer 24

Biscuspid aortic valve
Marfan’s syndrome
Coarctation

Question 25

3 shunts of coarctation

Answer 25

Ductus arteriosus
Foramen ovale
Ductus venosus

Question 26

3 types of coarctation

Answer 26

Pre-ductal
Ductal
Post-ductal

Question 27

Signs of coarctation

Answer 27

Cold legs

Poor leg pulses

Question 28

Pulse delay if coarctaation before left subclavian artery

Answer 28

Radial - radial delay

RIGHT radial-femoral delay

Question 29

Pulse delay if coarctation after left subclavian artery

Answer 29

Right and left radial-femoral delay