Cardiology

Question 0

Thoracic Aortic Aneurysm & Dissection

Answer 0

Associated with HTN, cystic medial necrosis (Marfans), tertiary syphilis, connective tissue disx (ED, scurvy, copper metab defects)
Generally not related to athero.

Dissection: intimal tear leads to false lumen
-tearing chest pain radiating to back, sweating, unequal pulses, mediastinal widening on CXR, pericardial tamponade, rupture

Type A: proximal can involve coronary artery, pericardium, carotids; more dangerous
Type B: involves distal descending thoracic aorta

Question 1

Abdominal Aortic Aneurysm

Answer 1

Fusiform aneurysm involving all layers (ie. not a dissection)
Aortic diameter > 3cm = AAA
Male smokers greater than 60yo associated with atherosclerosis
Midline pulsatile mass
Rupture: hypoTN, left flank pain, syncope, hematuria (venous congestion and rupture)
Usu at level of renal arteries –> NO VASO VASORUM