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Cardiovascular > Disease of the Thoracic Aorta > Flashcards

Disease of the Thoracic Aorta Flashcards

1
Q

Name the seven parts of the Aorta

A 
Annulus 
Aortic root 
Sinotubular junction 
Ascending thoracic aorta 
Aortic arch 
Descending thoracic aorta 
Abdominal aorta
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2
Q

What is the commonest cause of death in the West?

A

Atherosclerosis

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3
Q

What are the risk factors for atherosclerosis?

A 
Hypertension 
Hypercholesterolaemia 
Smoking 
Diabetes 
Family history 
Male
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4
Q

When does atherosclerosis usually begin?

A

Early childhood

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5
Q

What are the different stages in the atherosclerosis timeline?

A 
Foam cells 
Fatty streak 
Intermediate lesion 
Atheroma 
Fibrous plaque 
Complicated lesion/rupture
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6
Q

What can atherosclerosis cause?

A

Stroke
MI
Aneurysm

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7
Q

What is an aneurysm?

A

A localised enlargement of an artery caused by a weakening of the vessel wall

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8
Q

What are the different types of aneurysms?

A

True aneurysms
False aneurysm
Dissecting aneurysm

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9
Q

What are the two types of true aneurysms?

A

Saccular

Fusiform

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10
Q

What is a true aneurysm?

A

Weakness and dilation of the artery wall that involves all three layers

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11
Q

What is a true aneurysm associated with?

A 
Hypertension 
Atherosclerosis 
Smoking 
Collagen abnormalities 
Trauma 
Infection
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12
Q

What diseases can cause collagen abnormalities?

A

Marfan’s syndrome

Cystic medial necrosis

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13
Q

What are false aneurysms?

A

Rupture of the wall of the aorta with haematoma either contained by the thin adventitial layer or by the surrounding soft tissue

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14
Q

What can cause a false aneurysm?

A

Inflammation
Trauma
Iatrogenic

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15
Q

What happens as a result of a false aneurysm?

A

Ischaemia

Rupture

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16
Q

How can you tell if a person has a false aneurysm?

A

Thrills
Bruit
Pulsatile mass

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17
Q

What is a dissecting aneurysm?

A

When the wall of the aorta is ripped and blood flows into it separating the layers of the wall.

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18
Q

What are the possible signs and symptoms of a thoracic aneurysm?

A 
Asymptomatic 
SOB 
Heart failure 
Dysphagia and hoarseness 
Sharp chest pain radiating to back
Pulsatile mass 
Hypotension
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19
Q

What does acute aortic dissection count as?

A

A medical/surgical emergency

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20
Q

What causes aortic dissection?

A

Hypertension
Atherosclerosis
Trauma
Marfan’s syndrome

21
Q

What are the two types of aortic dissections?

A

Antegrade

Retrograde

22
Q

What are the different ways that an aortic dissection can rupture?

A

Back into the lumen

Externally into the pericardium or mediastinum

23
Q

What can dilation of the ascending aorta cause?

A

Acute aortic regurgitation

24
Q

What are the signs and symptoms of aortic dissection?

A

Tearing, severe chest pain radiating to the back
Collapse (tamponade, acute AR, external rupture)
Inferior ST elevation
Reduced or absent peripheral pulses/mismatch between sides
Hypotension/hypertension
Soft early diastolic murmur
Pulmonary oedema
Widening mediastinum

25
Q

What investigations should be done to check for aortic dissection?

A

CT
CXR
Ultrasound
MRI

26
Q

What are the treatment options for aortic dissection?

A

Surgery
Meticulous blood pressure control
Sodium nitroprusside puls beta blocker

27
Q

What is Takayasu’s arteritis?

A

A form of large vessel granulomatous vasculitis with massive intimal fibrosis and vascular narrowing. It normally effects the aorta and its main branches

28
Q

What can Takayasu’s arteritis cause?

A

Stenosis
Thrombosis
Aneurysm
Renal artery stenosis

29
Q

How is Takayasu’s arteritis treated?

A

Steroids

Surgery

30
Q

Which gender does Takayasu’ arteritis effect more?

A

Females

31
Q

What is Syphilis?

A

A STD caused by the bacteria, Treponema palladium, and can be treated by antibiotics

32
Q

What are the 3 types of tertiary syphilis?

A

Late neuro-syphillis
Gummatous syphillis
Cardiac syphillis

33
Q

What can cardiac syphillis cause?

A

Syphilitic aortic aneurysm

Aortic regurgitation

34
Q

What can cause congenital aortic aneurysms?

A

Bicuspid aortic valve
Marfan’s syndrome
Coarctation

35
Q

What is the most common congenital abnormality?

A

Bicuspid aortic valve

36
Q

What is a bicuspid aortic valve prone to?

A

Stenosis and/or regurgitation

37
Q

What is a bicuspid aortic valve associated with?

A

Coarctation

38
Q

How does a bicuspid aortic valve effect the aorta?

A

Reduces tensile strength

39
Q

How is a bicuspid aortic valve monitored?

A

With echo/MRI

40
Q

What is aortic coarctation?

A

Aortic narrowing close to where the Ductus arteriosus inserts

41
Q

What are the signs of coarctation?

A

Cold legs
Poor leg pulses
Radial-radial and right radial femoral delay if before left subclavian artery
Right and left radio-femoral delay with no radial-radial delay if after left subclavian artery

42
Q

What are the symptoms of coarctation in infancy?

A

Heart failure

Failure to thrive

43
Q

What are the symptoms of coarctation in later life?

A

Hypertension

44
Q

What imaging can be used to investigate for coarctation?

A

CXR

CMRI

45
Q

What is Marfan’s syndrome?

A

Connective tissue weakness

46
Q

How can marina’s syndrome effect the body?

A 
Aortic/mitral valve prolapse - regurgitation 
Cataracts 
Lens dislocation 
Aneurysm 
Dissection 
Pneumothorax 
Skeletal system
47
Q

What are the 3 types of coarctation?

A

Pre-ductal
Ductal
Post-ductal

48
Q

What is the most common type of coarctation in adults?

A

Post-ductal

Cardiovascular (34 decks)

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