Diseases of the Thoracic Aorta Flashcards
name the three cusps of the aortic valve
> left cusp
right cusp
non-coronary cusp
define aneurysm
a localised enlargement of an artery caused by a weakening of the vessel wall
define a true aneurysm
all three layers of the wall are involved
name two types of true aneurysm
fusiform
sacculated
what is a false aneurysm?
the wall of the aorta is ruptures with the haematoma either contained by the thin adventitial layer or the surrounding soft tissue.
how is a dissection different from a rupture?
the second an first layer are split but the vessel is still intact
why can aortic arch aneurysms be dangerous?
this is where the arteries come off
what are the signs and symptoms of a thoracic aneurysm?
> asymptomatic > shortness of breath > heart failure > dysphagia > hoarseness > sharp pain radiating to the back > pulsatile mass > hypotension
describe an aortic dissection
there is a tear in the inner wall of the aorta and the blood forces the walls apart. this can be acute or chronic.
describe a type a dissection on the Stanford scale
all dissections involving the ascending aorta regardless of the site of origin.
describe a type b dissection on the Stanford scale
all dissections not involving the ascending aorta
what are the aetiological factors for aortic dissection?
> hypertension
atherosclerosis
trauma
marfans syndrome
what may happen due to dilation of the ascending aorta?
acute aortic regurgitation
what are the symptoms of aortic dissection?
> tearing severe chest pain radiating to back
collapse
inferior st elevation
what might you find on examining someone with an aortic dissection?
> reduced/absent peripheral pulses > hypo/hypertension > soft early diastolic murmur > pulmonary oedema > widened mediastinum on chest xray
what is type a treatment for aortic dissection?
surgery
what is type b treatment for aortic dissection?
> meticulous blood pressure control
> sodium nitroprusside plus beta blocker
what is takayasu’s arteritis?
granulomatous vasculitis affecting the aorta and main branches.
what problems are associated with a bicuspid aortic valve?
> coarctation of the aorta
reduced tensile strength of the aorta
aneurysm and dissection
what would you use to monitor a bicuspid aortic valve?
> an echocardiography
> MRI
what is aortic coarctation?
aortic narrowing close to where the ductus arteriosus inserts
name 3 types of coarctation
> pre-ductal
ductal
post-ductal
what can post-ductal aortic coarctation cause?
hypertension in upper extremities and weak pulses in the lower limbs
what are the signs of coarctation?
> cold legs
poor leg pulses
radial-radial and right radial-femoral delay if it is before the left subclavian artery
right and left radio-femoral delay if it is after the left subclavian artery