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02. Cardiovascular System > Disease of the Aorta > Flashcards

Disease of the Aorta Flashcards

1
Q

<p>What comes from the</p>

<ol> <li>Left coronary sinus</li> <li>Right coronary sinus</li> <li>Posterior coronary sinus?</li></ol>

A

<p>The left aortic sinus gives rise to theleft coronary artery.</p>

<p>The right aortic sinus gives rise to theright coronary artery.</p>

<p>Usually, no vessels arise from the posterior aortic sinus, which is therefore known as thenon-coronarysinus.</p>

<p>Each aortic sinus can also be referred to as thesinus of Valsalva</p>

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2
Q

<p>What is the definition of an aneurysm?</p>

<p></p>

A

<p>A localised enlargement of an artery caused by a weakening of the vessel wall</p>

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3
Q

<p>What are the different types of aneurysm?</p>

A

<p>True aneurysms - Saccular and Fusiform</p>

<p>False Aneurysm</p>

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4
Q

<p>Which layers of the aorta does a true aneurysm involve?</p>

A

<p>All three layers</p>

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5
Q

<p>What are the risk factors for true aneurysm?</p>

A

<p>Hypertension</p>

<p>Atherosclerosis</p>

<p>Smoking</p>

<p>Collagen abnormalities (Marfan's)</p>

<p>Trauma</p>

<p>Infection (mycotic / syphilis)</p>

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6
Q

<p>What are the features of a false aneurysm?</p>

A

<p>A rupture of the wall of the aorta with the haemotoma either contained by the thin adventitial layer or by the surrounding soft tissue</p>

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7
Q

<p>What are the clinical features of a false aneurysm?</p>

A

<p>Thrill</p>

<p>Bruit</p>

<p>Pulsatile mass</p>

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8
Q

<p>What is the difference between a false aneurysm (pseudo aneurysm) and a dissecting aneurysm?</p>

A

<p>Pseudoaneurysm: Collection of blood that forms between the two outer layers of an artery, the muscularis and the adventitia.</p>

<p>Dissecting aneurysm: When blood from the vessel lumen tracks between the two inner layers, the intima and the muscularis.</p>

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9
Q

What are the different classifications of aortic aneurysms?

A
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10
Q

<p>What are potential signs and symptoms of aneurysms?</p>

A

<p>Dependant on location:</p>

<p></p>

<p>SOB</p>

<p>Heart Failure</p>

<p>SHarp Chest Pain radiating to the back - between shoulder blades (possible sign of dissection)</p>

<p>Pulsatile mass</p>

<p>Hypotension - due to compliance of the aorta</p>

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11
Q

<p>What is the Stanford classification of aortic dissection?</p>

A

<p>Type A - involves ascending aorta</p>

<p>Type B - Doesn't</p>

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12
Q

<p>What are the potential risk factors for dissection?</p>

A

<p>Hypertension</p>

<p>Atherosclerosis</p>

<p>Trauma</p>

<p>Marfan's Syndrome</p>

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13
Q

<p>What direction can the dissection progress in?</p>

A

<p>Antegrade or Retrograde Direction</p>

<p></p>

<p>Antegrade – arch to distal aorta</p>

<p>Retrogade – back to ascending aorta</p>

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14
Q

<p>What are the potential branches that an aortic dissection may occlude?</p>

A

<p>Mesenteric, carotid, renal or spinal</p>

<p></p>

<p>Carotid -Aortic dissection can present with neurological symptoms as a result of carotid blood occlusion</p>

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15
Q

<p>What are the potential complications of a ruptured dissection?</p>

A

<p>•Rupture - back into the lumen or externally in to pericardium (tamponade) or mediastinum</p>

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16
Q

<p>What is the effect of dissection on the ascending aorta?</p>

A

<p>May cause dilation and therefore aortic regurgitation</p>

17
Q

<p>What are the symptoms of aortic dissection?</p>

A

<div>•Tearing, severe chest pain (radiating to back)</div>

<div>•Collapse (tamponade, acute AR, external rupture)</div>

<div>•Beware inferior ST elevation</div>

<div>•~50% mortality pre-hospital</div>

18
Q

<p>What are the features of aortic dissection on examination?</p>

A

<p>Reduced / absent peripheral pulses (BP mismatch between sides)</p>

<p>Hypotension / hypertension</p>

<p>Soft early diastolic murmur (AR)</p>

<p>Pulmonary oedema</p>

<p>Widened mediastinum on X - Ray</p>

<p>Diagnosis can be confirmed by echocardiogram or CT scanning</p>

19
Q

What is the treatment of dissection?

A
20
Q

<p>What is the pathology of takayasu's arteritis?</p>

A

<p>Stenosis due to fibrosis - scarring of the blood vessels due to repeated inflammation (bracocephalic, left common carotid, left subclavean)</p>

<p></p>

<p>Granulomas present in artery wallls</p>

<p></p>

21
Q

<p>What are the common signs and symptoms of Takayasu's arteritis?</p>

A

<p>Weak / absent peripheral pulses, difference in blood pressure between arms is possible</p>

<p>Bad/blurry/double vision</p>

<p>Reduced cognition</p>

<p>Bruit and thrill in carotid if stenosed</p>

22
Q

<p>What is the treatment for takayasu's arteritis?</p>

A

<p>Steroids</p>

<p>Surgery</p>

23
Q

<p>What is cardiac syphilis?</p>

A

<p>Infection of theheartand relatedbloodvessels by thesyphilisbacteria</p>

24
Q

<p>What are the conditions associated with cardiac syphilis?</p>

A

<p>Narrowing of thebloodvessels that supply blood to theheart, which may lead toheart attackand possibly death.</p>

<p>Damage to heart valves that may lead toheart failure. (aortic regurgitation)</p>

<p>Aortic aneurysm. If a vessel becomes weak enough, it can rupture and cause death.</p>

25
Q

<p>What are the types of congenital aortic aneurysm?</p>

A

<p>•Bicuspid Aortic Valve</p>

<p>•Marfan’s Syndrome</p>

<p>•Coarctation</p>

26
Q

<p>What causes the formation of a bicuspid valve?</p>

A

<p>The fusion of two cusps, so only two functional cusps</p>

27
Q

<p>What are the complications of bicuspid aortic valve?</p>

A

<p>Prone to stenosis and regurgitation</p>

<p>Associated with coarctation</p>

<p>Abnormal aorta, meaning reduced tensile strength</p>

<p>Prone to aneurysm / dissection</p>

28
Q

<p>How do you monitor a bicuspid valve?</p>

A

<p>Echo / MRI</p>

29
Q

<p>Where does coarctation occur?</p>

A

<p>Close to where the ductus arteriosus inserts (ligamentum arteriosum)</p>

30
Q

What are the three types of coarctation?

A
31
Q

<p>What are the signs of coractation?</p>

A

<p>Cold legs</p>

<p>Poor leg pulses</p>

<p>If before left subclavian artery: radial - radial and right radial - femoral delay</p>

<p>If after left subclavian artery: No radial - radial delay, but right and left radio - femoral delay</p>

32
Q

What are the symptoms of coarctation?

A
33
Q

<p>What is one of the signs of coarctation on an X - ray?</p>

A

<p>Rib notching (colalteral circulation)</p>

34
Q

What are the pathologies associated with marfan’s syndrome?

A

02. Cardiovascular System (72 decks)

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