Diseases of the Thoracic Aorta

Question 1

What are the RISK FACTORS for ATHEROSCLEROSIS?

Answer 1

1) Smoking
2) Hypercholesterolaemia
3) Hypertension
4) Diabetes Mellitus
5) Family History
6) Male > Female

Question 2

What are the possible COMPLICATIONS of atherosclerosis?

Answer 2

1) Stroke
2) Myocardial Infarction
3) Aneurysm

Question 3

What is an ANEURYSM?

Answer 3

1) Localised Enlargement of an Artery

2) Due to Weakening of the Vessel Wall

Question 4

What are the different TYPES of aneurysm?

Answer 4

1) Saccular/Berry
2) Fusiform (Bilateral Dilatation)
3) False
4) Dissecting

Question 5

What are potential CAUSES of an aneurysm?

Answer 5

1) HTN
2) Atherosclerosis
3) Smoking
4) Collagen Abnormalities/Connective Tissue Disorders, i.e. Marfan’s
5) Trauma
6) Infection

Question 6

What are some of the SYMPTOMS of a THORACIC aneurysm?

Answer 6

*Can be Asymptomatic

1) Dyspnoea
2) Dysphagia
3) Dysphonia
4) Chest Pain - Sharp and Radiating to the Back, between the Shoulder Blades (If Dissection)

Question 7

What are the SIGNS of a THORACIC aneurysm?

Answer 7

1) Pulsatile Mass

2) Hypotension

Question 8

What is the MOST COMMONLY USED thoracic aortic dissection CLASSIFICATION?

Answer 8

Stanford

Question 9

Where in the thoracic aorta would a TYPE A dissection occur?

Answer 9

Ascending Aorta

Question 10

Where in the thoracic aorta would a TYPE B dissection occur?

Answer 10

Anywhere EXCEPT the Ascending Aorta

Question 11

What are the SYMPTOMS of an AORTIC DISSECTION?

Answer 11

1) Severe Chest Pain - Tearing and Radiating to the Back, between the Shoulder Blades
2) Syncope

Question 12

What are some of the SIGNS of an AORTIC DISSECTION?

Answer 12

1) < or Absent Peripheral Pulses
2) < or > BP
3) Soft Early Diastolic Murmur
4) Pulmonary Oedema

Question 13

What INVESTIGATIONS would be used to DIAGNOSE an AORTIC DISSECTION?

Answer 13

1) CXR
2) Echo
3) ECG
4) CT Scan

Question 14

What would be the likely FINDINGS on CXR for aortic dissection?

Answer 14

1) Widened Mediastinum/Cardiomegaly

2) Pulmonary Oedema

Question 15

What would be a likely FINDING on ECG for aortic dissection?

Answer 15

Inferior ST Elevation

Question 16

What would be a likely FINDING on ECHO for aortic dissection?

Answer 16

1) Aortic Regurgitation

2) Dilatation of Aortic Root

Question 17

What would be the TREATMENT for a TYPE A aortic dissection?

Answer 17

Surgery

Question 18

What would be the TREATMENT for a TYPE B aortic dissection?

Answer 18

1) Meticulous BP Control

2) Na+ Nitroprusside + Beta Blocker

Question 19

What is a possible INFLAMMATORY aetiology of aortic disease?

Answer 19

Takayasu Arteritis

Question 20

What is TAKAYASU ARTERITIS?

Answer 20

1) Granulomatous Vasculitis
2) Often Affecting the Aorta and its Main Branches
3) Causing Stenosis; Thrombosis; Aneurysms, etc

Question 21

Give 3 potential CONGENITAL CAUSES of aortic aneurysm:

Answer 21

1) Marfan Syndrome
2) Bicuspid Aortic Valve
3) Coarctation of the Aorta

Question 22

What are the TREATMENTS for Takayasu Arteritis?

Answer 22

1) Steroids

2) Surgery

Question 23

What are the 3 TYPES of COARCTATION of the AORTA?

Answer 23

1) Pre-Ductal
2) Ductal
3) Post-Ductal

Question 24

Where in the aorta does COARCTATION OCCUR?

Answer 24

Stenosis Close to where the Ductus Arteriosus Inserts (Ligamentum Arteriosum)

Question 25

What is the MOST COMMON FORM of coarctation in ADULTS?

Answer 25

Post-Ductal

Question 26

What are the COMMON SIGNS of coarctation in ADULTS?

Answer 26

1) Hypertension in the Upper Extremities
2) < Pulses in the Lower Extremities
* Radio-Femoral Delay
3) Rib-Notching (Seen on CXR)
4) Cold Legs

Question 27

What are the SYMPTOMS of coarctation in INFANCY?

Answer 27

1) Heart Failure

2) Failure to Thrive

Question 28

What INVESTIGATIONS would be used to DIAGNOSE coarctation?

Answer 28

1) CXR - Rib Notching

2) Cardiac MRI - Location of the Coarctation