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Cardiovascular System > Aortic Disease > Flashcards

Aortic Disease Flashcards

1
Q

What are the complications of atherosclerosis?

4

A

MI
ACS
Stroke
aneurysm

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2
Q

What are the classifications of aneurysms by type?

4

A
  1. True:
    - saccular
    - fusiform
  2. False
  3. Dissecting
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3
Q

What is an aneurysm?

A

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

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4
Q

What is a true aneurysm?

1

A
  • involves all 3 layers of artery wall.
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5
Q

What is a saccular aortic aneurysm?

A

One area of the vessel wall is weakened and causes a sac like shape to form in the artery wall.

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6
Q

What is a fusiform abdominal aortic aneurysm?

A

Widening of the complete diameter of the artery to create a swollen like artery.

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7
Q

What are true aneurysms associated with?

6

A 
Hypertension
Atherosclerosis
Smoking
Collagen abnormalities 	(e.g. Marfan’s, cystic medial necrosis)
Trauma
Infection (mycotic/syphillis)
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8
Q

What is a false aneurysm?

A

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

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9
Q

What are false aneurysms associated with?

8

A
  • Inflammation (e.g. endocarditis with septic emboli)
  • Trauma
  • Iatrogenic
  • Thrill
  • Bruit
  • Pulsatile mass
  • Ischaemia
  • Rupture
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10
Q

What are the signs and symptoms of thoracic aneurysms (note what each might indicate)?

6

A
  • asymptomatic!
  • dysphagia/hoarseness (ascending aorta)
  • SOB
  • pulsatile mass (false)
  • hypotension
  • sharp chest pain, radiating to back - possible dissection.
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11
Q

What is an aortic dissection?

4

A
  • Tear in the inner wall of aorta
  • Blood forces walls apart
  • Acute –medical/surgical emergency
  • Chronic
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12
Q

According to DeBakey classifications, what is a Type 1 thoracic aortic dissection?

A
  • originates in the ascending aorta

- propagates at least to the aortic arch, and usually beyond it distally.

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13
Q

According to DeBakey classifications, what is a Type 2 thoracic aortic dissection?

A
  • originates and confined to the ascending aorta
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14
Q

According to DeBakey classifications, what is a Type 3 thoracic aortic dissection?

A
  • originates in the descending thoracic aorta

- usually propagates distally downward.

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15
Q

According to Stanford classifications, what is a Type A thoracic aortic dissection?

A
  • involving the ascending aorta
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16
Q

According to Stanford classifications, what is a Type B thoracic aortic dissection?

A
  • all dissections NOT involving the ascending aorta.
17
Q

What are some of the causes of aortic dissections?

4

A
  • hypertension
  • atherosclerosis
  • Marfan’s syndrome (collagen defect syndrome)
  • Trauma
18
Q

What are the complications of a ruptured aortic dissection?

2

A
  • in pericardium = cardiac tamponade

- in ascending aorta = acute AR

19
Q

What are the symptoms of aortic dissection?

2

A
  • severe chest pain, radiating to back

- collapse (acute AR, tamponade, external rupture)

20
Q

What are the signs of an aortic dissection?

5

A
  • absent peripheral pulses
  • hypotension/hypertension
  • soft early diastolic murmur (AR)
  • CXR (widened mediastinum)
  • pulmonary oedema
21
Q

What investigations might aid in reaching a diagnosis?

A
  • CXR
  • ECG
  • Echo
  • Exam
22
Q

What would be the treatment for a type A (ascending aorta) dissection?

A
  • acute emergency

- surgery

23
Q

What would be the treatment for a type B (non-ascending aorta) dissection?

3

A
  • meticulous BP control

- sodium nitroprusside plus beta blocker

24
Q

Give an example of an infection which might lead to aortic dissection?

A

syphillis

25
Q

What is the causative agent of syphillis?

A

Treponema pallidum

26
Q

What are the different stages of syphillis?

A

primary
secondary
tertiary

27
Q

Without treatment, what might patients develop in the tertiary stage of syphillis?

3

A

late neuro-syphillis
gummatous syphillis
cardiac syphillis

28
Q

What can cardiac syphillis result in?

2

A

Syphilitic aortitis – aneurysm

Aortic regurgitation

29
Q

What are some congenital causes of aortic aneurysm/abnormality?

3

A
  • bicuspid aortic valve
  • Marfan’s syndrome
  • Coarctation
30
Q

What is aortic coarctation?

A

Narrowing of the aorta below the left subclavian artery.

31
Q

Where does the narrowing of the aorta take place in coarctation?

A

Aortic narrowing close to where Ductus arteriosus inserts
(ligamentum arteriosum):

3 types:

  • Pre-ductal (5% turner’s) can be life-threatening if severe narrowing
  • Ductal
  • Post-ductal –most common in adults – hypertension in upper extremities, weak pulses in lower limbs.
32
Q

What are the signs of coarctation?

A
  • Cold legs
  • Poor leg pulses
  • If before left subclavian artery:
    • radial–radial and RIGHT radial-femoral delay
  • If after left subclavian artery:
    • No radial-radial delay
    • Right and left radio-femoral delay
33
Q

Describe the characteristics of Marfan’s syndrome.

________ gene.

A

Fibrillin 1

34
Q

Describe the characteristics of Marfan’s syndrome.

_______ ______ weakness

A

connective tissue

35
Q

Describe the characteristics of Marfan’s syndrome.

cardiac issues?

3

A
  • aortic/mitral valve prolapse (regurgitation)
  • aortic dissection
  • aneurysm
36
Q

Describe the characteristics of Marfan’s syndrome.

lung issues?

A

pnemothorax

Cardiovascular System (37 decks)

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