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02. Cardiovascular System > Aortic Disease - Pathophysiology, Presentation, Investigation & Therapy > Flashcards

Aortic Disease - Pathophysiology, Presentation, Investigation & Therapy Flashcards

1
Q

What are examples of aortic diseases?

A

Atherosclerosis

Aneurysm

Coarctation

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2
Q

What are risk factors for atherosclerosis?

A

Hypertension

Hypercholesterolaemia

Smoking

Diabetes

Family history

Males more than females (until menopause)

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3
Q

Are males or females more at risk of atherosclerosis?

A

Males, until females undergo menopause

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4
Q

What can atherosclerosis lead to?

A

Stroke

Myocardial infarction

Aneurysm

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5
Q

What is an aneurysm?

A

Localised enlargement of an artery caused by a weakening of the vessel wall

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6
Q

What is a localised enlargement of an artery caused by a weakening of the vessel wall called?

A

Aneurysm

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7
Q

How can aneurysms be classified?

A

By being true or false, and by the site

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8
Q

What are examples of true aneurysms?

A

Saccular and fusiform

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9
Q

What is A?

A

True aneurysm

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10
Q

What is B?

A

Succular aneurysm

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11
Q

What is C?

A

Fusiform aneurysm

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12
Q

What is D?

A

False aneurysm

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13
Q

What is E?

A

Dissecting aneurysm

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14
Q

What is a true aneurysm?

A

Weakness and dilation of the wall, involving 3 layers

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15
Q

What are true aneurysms associated with?

A

Hypertension

Atherosclerosis

Smoking

Collagen abnormalities (such as Marfan’s)

Trauma

Infection

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16
Q

What is a false aneurysm?

A

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

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17
Q

What is a false aneurysm associated with?

A

Inflammation (such as endocarditis)

Trauma

Iatrogenic

Thrill

Bruit

Pulsatile mass

Ischaemia

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18
Q

What are different classifications of aortic aneurysms by site?

A

Normal

Ascending aorta

Aortic arch

Descending aorta

Abdominal aorta

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19
Q

What are signs and symptoms of thoracic aneurysms?

A

Asymptomatic

Based on location:
Shortness of breath or even heart failure
Dysphagia and hoarseness (ascending aorta, chronic)
Sharp chest pain radiating to back (dissection)
Pulsatile mass
Hypotension

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20
Q

What is aortic dissection?

A

Tear in the inner wall of the aorta

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21
Q

What forces the walls apart in an aortic dissection?

A

Blood

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22
Q

What could an aortic dissection occlude?

A

Branches (such as mesenteric, carotid, renal or spinal)

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23
Q

What are the classifications of aortic dissection?

A

Type A (all dissections involving the ascending aorta, regardless of site of origin)

Type B (all dissections not involving the ascending aorta)

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24
Q

What are type A aortic dissections?

A

All dissections involving the ascending aorta regardless of site of origin

25
Q

What are type B aortic dissections?

A

All dissections not involving the ascending aorta

26
Q

What are aetiological factors for aortic dissection?

A

Hypertension

Atherosclerosis

Trauma

Marfan’s syndrome

27
Q

What are symptoms of aortic dissection?

A

Tearing, severe chest pain (radiating to back)

Collapse

Inferior ST elevation

28
Q

What can be seen on the examination of aortic dissection?

A

Reduced or absent peripheral pulses

Hypo/hypertension

Soft early diastolic murmur

Pulmonary oedema

29
Q

What investigations are done for aortic dissection?

A

Chest X-ray

Diagnosis can be confirmed by echocardiogram or CT

30
Q

What can confirm the diagnosis of aortic dissection?

A

Echocardiogram or CT

31
Q

What does the treatment of aortic dissection depend on?

A

Whether is is type A or B

32
Q

What is the treatment for type A aortic dissection?

A

Surgery

33
Q

What is the treatment for type B aortic dessection?

A

Meticulous blood pressure control

Sodium nitroprusside plus beta blocker

34
Q

What could cause aortic dissection?

A

Infections and inflammation

35
Q

What is an example of an infection that could cause aortic dissection?

A

Syphillis

36
Q

What is an example of inflammation that could cause aortic dissection?

A

Takayasu’s arteritis

37
Q

What is Takayasu’s arteritis?

A

Granulomatous vasculitis that affects aorta and main branches

38
Q

Does Takayasu’s arteritis affect more males or females?

A

Females

39
Q

What are some causes of Takayasu’s arteritis?

A

Stenosis

Thrombosis

Aneurysm

Renal artery stenosis

40
Q

What is the treatment of Takayasu’s arteritis?

A

Steroids

Surgery

41
Q

What is syphilis?

A

STD caused by treponema pallidum

42
Q

What is syphilis caused by?

A

Treponema pallidum

43
Q

What are the different kinds of syphilis?

A

Primary and secondary

44
Q

What can prevent the late stages of syphilis?

A

Antibiotics

45
Q

What can congenital aortic aneurysm be caused by?

A

Bicuspid aortic valve

Marfan’s syndrome

Coarctation

46
Q

What are the problems of a bicuspid aortic valve?

A

Prone to stenosis and regurgitation

Associated with coarctation

47
Q

What is the prevalence of bicuspid aortic valve?

A

1-2%

48
Q

What is aortic coarctation?

A

Narrowing of the aorta

49
Q

What is narrowing of the aorta called?

A

Aortic coarctation

50
Q

What are the 3 associated shunts due to aortic coarctation?

A

Ductus arteriosus

Foramen ovale

Ductus venosus

51
Q

Where does aortic coarctation occur?

A

Close to where the ductus arteriosus insets (ligamentum arteriosum)

52
Q

What are the 3 types of aortic coarctation?

A

Pre-ductal

Ductal

Post-ductal

53
Q

What are signs of coarctation?

A

Cold legs

Poor leg pulses

If before subclavian artery (radial-radial and righ radial-femoral delay)

If after subclavian artery (no radial-radial delay, right and left radio-femoral delay)

54
Q

What are symptoms of coarctation?

A

Heart failure and failure to thrive in infancy

Hypertension in later life

55
Q

What imaging is used to diagnosis aortic coarctation?

A

Chest X-ray

Chest MRI

56
Q

What is Marfan’s syndrome?

A

Genetic disorder that causes connective tissue weakness

57
Q

What gene causes Marfan’s syndrome?

A

Fibrillin 1 gene

58
Q

What does Marfan’s syndrome lead to?

A

Aortic/mitral valve prolapse or regurgitation

Skeletal system problems

Eye problems

Aneurysm, dissection (vascular problems)

Lung problems

02. Cardiovascular System (72 decks)

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