Diseases of the thoracic aorta

Question 1

Describe the location of the thoracic aorta

Answer 1

Lower border of the 4th thoracic vertebra to the lower border of the 12th thoracic vertebra at the aortic hiatus in the diaphragm

Question 2

Define aneurysm

Answer 2

Localised enlargement of an artery caused by weakening of the vessel wall

Question 3

Describe different types of aneurysm

Answer 3

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

Question 4

What is associated with true aneurysms?

Answer 4

Hypertension
Atherosclerosis
Smoking
Collagen abnormalities
Trauma
Infection

Question 5

What is associated with false aneurysms?

Answer 5

Inflammation
Trauma
Iatrogenic (caused while in healthcare)

Question 6

Where about would you expect the aneurysm to be if the patient is hoarse or experiencing dysphagia?

Answer 6

Ascending aorta aneurysm

Question 7

Describe the DeBakey classification system of aneurysms

Answer 7

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

Question 8

Describe the Stanford classification system of aneurysms

Answer 8

A - Involves ascending aorta only

B - involves descending aorta only

Question 9

What can cause dissection of the aorta?

Answer 9

Hypertension
Atherosclerosis
Trauma
Marfans syndrome

Question 10

What treatment is suggested for type A aneurysms?

Answer 10

Surgery

Question 11

What treatment is suggested for type B aneurysms?

Answer 11

Blood pressure control
Sodium nitropusside
Beta blockers

Question 12

What is Takayasu’s arteritis associated with?

Answer 12

Stenosis
Thrombosis
Aneurysms
Renal artery stenosis

Question 13

What organism causes syphilis?

Answer 13

Treponema Pallidum

Question 14

What can cause congenital aortic aneurysms?

Answer 14

Marfans syndrome
Bicuspid aortic valve
Coarctation

Question 15

What can cause coarctation of the aorta?

Answer 15

3 possible shunts:

• Ductus arteriosus
• Foramen ovale
• Ductus venosus

Question 16

What type of coarctation is common in those with Turners syndrome?

Answer 16

Pre-ductal

Question 17

Where are most coarctations found in adults?

Answer 17

Post-ductal

Question 18

Describe some clinical signs of coarctation

Answer 18

Cold legs
Poor leg pulses
Pulse delays

Question 19

What type of coarctation is associated with a radial-radial delay, as well as a right radial-femoral delay?

Answer 19

If before left subclavian artery

Question 20

What type of coarctation is associated with non radial-radial delay but a double sided radio-femoral delay?

Answer 20

After left subclavian artery

Question 21

Describe some symptoms of correction in infancy

Answer 21

Heart failure

Failure to thrive

Question 22

Describe some symptoms of correction in later life

Answer 22

Hypertension

Question 23

What causes Marfans syndrome?

Answer 23

Mutation in fibrillin 1 gene, leading to connective tissue weakness

Question 24

What cardiovascular effects are seen in Marfans?

Answer 24

Atrial/mitral valse prolapse due to regurgitation
Aneurysms
Dissection