Cardiology - Aortic Diseases Flashcards
Which connective tissue disorders are associated with THORACIC AORTIC ANEURYSMS
These result in MEDIAL DEGENERATION
- Marfan’s
- Ehler’s Danlos Syndrome Type IV
- Loeys Dietz Syndrome
Which genetic diseases are associated with THORACIC AORTIC ANEURYSMS
- Familial Thoracic Aortic Aneurysm and Aortic Dissection (TAAD) Syndrome
- SMAD3 mutation
- Bicuspid aortic valve
- Turner Syndrome
Clinical features of Thoracic Aortic Aneurysm
- usually asymptomatic
- compression: hoarse / stridor / dysphagia
- rupture
- DIASTOLIC AR murmur
What type of murmur is in Thoracic Aortic Aneurysm?
Diastolic AR murmur
CXR findings in Thoracic Aortic Aneurysm
- widened mediastinum
- compression of trachea or left main bronchus
Leading cause of death in aortic aneurysms?
Rupture
Increased risk of rupture in THORACIC aortic aneurysm
- > 5cm
- Rapid rate of expansion is INDEPENDENT risk factor
- Pregnant
- Marfan
- Female
Surgical Thresholds in Thoracic Aortic Aneurysms
Asymptomatic: >5.5cm (or if growth is >0.5cm/year)
Genetic condition: >5.0cm
Bicuspid Ao: >5.5cm BUT if other risk factor for dissection is present then >5cm
Additional medication management THORACIC aortic aneurysm in Marfans?
Medications that reduce rate of growth:
Beta blockers
Losartan
How often to do an echo to monitor thoracic aortic aneurysm?
Annually
Screening for Abdominal Ao Aneurysm?
Screening in men aged 64-75 years old is associated with reduced risk of aneurysm-related death
When to ultrasound in ABDOMINAL AORTIC ANEURYSM?
- 5 - 4.4cm: Annual
4. 5 - 5.4cm 6-monthly
When to repair in ABDOMINAL AORTIC ANEURYSM?
> 5.5cm
Women if >5cm
Progression >0.5cm in 6 months
Symptoms
Difference between Type A and B Aortic Aneurysms?
Type A: Originates in Ascending Aorta
Type B: Originates BELOW the L subclavian artery
Difference between DeBakey Classification of Aortic Aneurysms?
Type I: Originates in ascending aorta and goes to arch
Type II: Originates and confined to ascending aorta
Type III: Originates in descending aorta
