Diseases of the Thoracic Aorta Flashcards
What are the RISK FACTORS for ATHEROSCLEROSIS?
1) Smoking
2) Hypercholesterolaemia
3) Hypertension
4) Diabetes Mellitus
5) Family History
6) Male > Female
What are the possible COMPLICATIONS of atherosclerosis?
1) Stroke
2) Myocardial Infarction
3) Aneurysm
What is an ANEURYSM?
1) Localised Enlargement of an Artery
2) Due to Weakening of the Vessel Wall
What are the different TYPES of aneurysm?
1) Saccular/Berry
2) Fusiform (Bilateral Dilatation)
3) False
4) Dissecting
What are potential CAUSES of an aneurysm?
1) HTN
2) Atherosclerosis
3) Smoking
4) Collagen Abnormalities/Connective Tissue Disorders, i.e. Marfan’s
5) Trauma
6) Infection
What are some of the SYMPTOMS of a THORACIC aneurysm?
*Can be Asymptomatic
1) Dyspnoea
2) Dysphagia
3) Dysphonia
4) Chest Pain - Sharp and Radiating to the Back, between the Shoulder Blades (If Dissection)
What are the SIGNS of a THORACIC aneurysm?
1) Pulsatile Mass
2) Hypotension
What is the MOST COMMONLY USED thoracic aortic dissection CLASSIFICATION?
Stanford
Where in the thoracic aorta would a TYPE A dissection occur?
Ascending Aorta
Where in the thoracic aorta would a TYPE B dissection occur?
Anywhere EXCEPT the Ascending Aorta
What are the SYMPTOMS of an AORTIC DISSECTION?
1) Severe Chest Pain - Tearing and Radiating to the Back, between the Shoulder Blades
2) Syncope
What are some of the SIGNS of an AORTIC DISSECTION?
1) < or Absent Peripheral Pulses
2) < or > BP
3) Soft Early Diastolic Murmur
4) Pulmonary Oedema
What INVESTIGATIONS would be used to DIAGNOSE an AORTIC DISSECTION?
1) CXR
2) Echo
3) ECG
4) CT Scan
What would be the likely FINDINGS on CXR for aortic dissection?
1) Widened Mediastinum/Cardiomegaly
2) Pulmonary Oedema
What would be a likely FINDING on ECG for aortic dissection?
Inferior ST Elevation
What would be a likely FINDING on ECHO for aortic dissection?
1) Aortic Regurgitation
2) Dilatation of Aortic Root
What would be the TREATMENT for a TYPE A aortic dissection?
Surgery
What would be the TREATMENT for a TYPE B aortic dissection?
1) Meticulous BP Control
2) Na+ Nitroprusside + Beta Blocker
What is a possible INFLAMMATORY aetiology of aortic disease?
Takayasu Arteritis
What is TAKAYASU ARTERITIS?
1) Granulomatous Vasculitis
2) Often Affecting the Aorta and its Main Branches
3) Causing Stenosis; Thrombosis; Aneurysms, etc
Give 3 potential CONGENITAL CAUSES of aortic aneurysm:
1) Marfan Syndrome
2) Bicuspid Aortic Valve
3) Coarctation of the Aorta
What are the TREATMENTS for Takayasu Arteritis?
1) Steroids
2) Surgery
What are the 3 TYPES of COARCTATION of the AORTA?
1) Pre-Ductal
2) Ductal
3) Post-Ductal
Where in the aorta does COARCTATION OCCUR?
Stenosis Close to where the Ductus Arteriosus Inserts (Ligamentum Arteriosum)
What is the MOST COMMON FORM of coarctation in ADULTS?
Post-Ductal
What are the COMMON SIGNS of coarctation in ADULTS?
1) Hypertension in the Upper Extremities
2) < Pulses in the Lower Extremities
* Radio-Femoral Delay
3) Rib-Notching (Seen on CXR)
4) Cold Legs
What are the SYMPTOMS of coarctation in INFANCY?
1) Heart Failure
2) Failure to Thrive
What INVESTIGATIONS would be used to DIAGNOSE coarctation?
1) CXR - Rib Notching
2) Cardiac MRI - Location of the Coarctation
