Diseases of the thoracic aorta Flashcards
Describe the location of the thoracic aorta
Lower border of the 4th thoracic vertebra to the lower border of the 12th thoracic vertebra at the aortic hiatus in the diaphragm
Define aneurysm
Localised enlargement of an artery caused by weakening of the vessel wall
Describe different types of aneurysm
True - saccular or fusiform, involves all 3 layers, weakness and dilatation
False - doesn’t involve all 3 layers, rupture of wall and bleed into layers
What is associated with true aneurysms?
Hypertension Atherosclerosis Smoking Collagen abnormalities Trauma Infection
What is associated with false aneurysms?
Inflammation
Trauma
Iatrogenic (caused while in healthcare)
Where about would you expect the aneurysm to be if the patient is hoarse or experiencing dysphagia?
Ascending aorta aneurysm
Describe the DeBakey classification system of aneurysms
I - Originates in ascending aorta and affects descending aorta
II - Originates in ascending aorta only
III - Originates in descending aorta, can drift up a bit
Describe the Stanford classification system of aneurysms
A - Involves ascending aorta only
B - involves descending aorta only
What can cause dissection of the aorta?
Hypertension
Atherosclerosis
Trauma
Marfans syndrome
What treatment is suggested for type A aneurysms?
Surgery
What treatment is suggested for type B aneurysms?
Blood pressure control
Sodium nitropusside
Beta blockers
What is Takayasu’s arteritis associated with?
Stenosis
Thrombosis
Aneurysms
Renal artery stenosis
What organism causes syphilis?
Treponema Pallidum
What can cause congenital aortic aneurysms?
Marfans syndrome
Bicuspid aortic valve
Coarctation
What can cause coarctation of the aorta?
3 possible shunts:
- Ductus arteriosus
- Foramen ovale
- Ductus venosus
What type of coarctation is common in those with Turners syndrome?
Pre-ductal
Where are most coarctations found in adults?
Post-ductal
Describe some clinical signs of coarctation
Cold legs
Poor leg pulses
Pulse delays
What type of coarctation is associated with a radial-radial delay, as well as a right radial-femoral delay?
If before left subclavian artery
What type of coarctation is associated with non radial-radial delay but a double sided radio-femoral delay?
After left subclavian artery
Describe some symptoms of correction in infancy
Heart failure
Failure to thrive
Describe some symptoms of correction in later life
Hypertension
What causes Marfans syndrome?
Mutation in fibrillin 1 gene, leading to connective tissue weakness
What cardiovascular effects are seen in Marfans?
Atrial/mitral valse prolapse due to regurgitation
Aneurysms
Dissection
