Case 3 Flashcards
What’s the difference between true and false aneurysms?
True involved all layers
False is an extravascular hematoma communicating with intravascular lumen
What causes morbidity in aneurysms?
1- Ruptures
2- impingement on other structures
3- occlusion of proximal vessels
4- embolism from thrombus
What are the 3 pathogenic features causing aneurysms?
1- poor intrinsic quality of vessel matrix
2- imbalance of matrix synthesis and degradation
3- loss of medial smooth muscle cell or change in its matrix
What causes poor intrinsic quality of vessel matrix?
1- Marfan syndrome
2- Loeys-Dietz syndrome
3- Ehlers- Danlos syndrome
4- scurvy
What causes an imbalance in matrix synthesis and degradation?
Increase in MMP activity
What causes loss of smooth muscle cells?
1- Atherosclerotic plaque which impedes oxygen
2- stenosis of vasa vasorum
What is cystic medial degeneration?
1- smooth muscle cell loss or degeneration
2- loss of normal ECM synthesis
3- increased production of glycosaminoglycans
What are the most common causes of aneurysms?
1- atherosclerosis
2- hypertension
What causes an acceleration of vascular wall destruction?
Mycotic aneurysms
Where do true aneurysms usually occur?
Below renal arteries above iliac bifurcation
Which type of aneurysm contains poorly organized mural thrombus and severe complex atherosclerosis?
Abdominal aortic
What are the complications of abdominal aortic aneurysm?
1- thromboembolism
2- rupture
3- compression of structures
4- occlusion of branch vessels
Dense periaortic fibrosis and transmural lymphoplasmacytic infiltrate is seen where?
In AAA
What is the most common causes of Thoracic aortic aneurysm?
Hypertension
Aortic valve insufficiency is seen where?
Thoracic aortic aneurysm
Which type of femoral artery aneurysm is associated with echymosis, progressive swelling, and pain?
Introgenic false aneurysms
A patient presents with haemodynamically significant bleeding that tracked into retroperitoneum and caused SHOCK. What is your diagnosis?
Traumatic pseudo aneurysm
Which is the slowest enlarging femoral aneurysm?
Anastomotic false aneurysms
What causes mycotic femoral aneurysms?
Needle puncture used for drugs
What causes death is aortic dissection?
Massive hemorrhage or cardiac tamponade
What causes an intramural hematoma without an intimal tear?
Vasa vasorum rupture
Retrograde dissection causes what?
Coronary compression or hemopericardium with tamponade
Anterograde dissection?
Extends into great arteries
A patient presents with excruciating pain in the chest that radiates to the back. What is your diagnosis?
Aortic dissection
