Disease of the Aorta

Question 1

ligamentum arteriosm is:

Answer 1

part that connects aorta to thoracic wall

-damaged in car accidents

Question 2

thoracic aortic aneurysm:

-symptoms

Answer 2

• asymptomatic (incidental finding)
• hoarseness secondary to stretching of L recurrent laryngeal nerve
• stridor due to bronchial compression
• dyspnea due to lung compression
• plethora from SVC compression
• dysphagia due to esophageal compression
• HF due to aortic regurg
• chest pain secondary to leaky aneurysm
• neck, jaw, back pain
• end organ involvement

Question 3

most common reason for aortic disease?

Answer 3

-HTN

Others:
-atherosclerosis
-marfans
-osteogenesis imperfecta
-ehlers danlos
......

Question 4

Law of laplace:

Answer 4

more diameter= more wall stress

Question 5

Abdominal aortic aneurysm screening:

Answer 5

• recommend a one time screen in males 65 yo or older (UltaSound])
• males and females with a family history of AAA may be screened as early as 55yo

Question 6

aortic dissection -symtpoms

Answer 6

sharp sudden onset ripping constant chest pain radiating to the back

Question 7

Management of aortic dissection:

Answer 7

• cardiothoracic surgery consult ASAP
• use beta blockers to manage BP to about 12-80
• resuscitate or vasopressors if hypotensive
• image promptly
• ascending aortic disscetions need quick surgery
• descending aortic dissections can be medically managed.

Question 8

Aortic disection diagnosis methods

Answer 8

-spiral CT-quick (GOLD STANDARD) =shows two distinct lumens with intimal flap