Dissecting Aortic Aneurysm Flashcards

1
Q

what are the 3 layers in the Aorta

A

intima, media, and adventitia

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2
Q

What is a spontaneous or traumatic tear in the intimal layer of the aorta causing dissection of the inner and middle walls of the aorta?

A

Aortic dissection

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3
Q

Type a or B dissection
Involves the arch of the aorta proximal to the left
subclavian artery

A

A

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4
Q

Type a or B dissection

dissection occurs in the proximal descending aorta

A

B

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5
Q

True/false
Spontaneous dissections are rarely associated with hypertension, connective tissue disorders (Marfan syndrome), bicuspid aortic valve, pregnancy, and coarctation of the aorta.

A

False

HIGHLY associated

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6
Q

What are the symptoms of Aortic Aneurysm

A

Sudden severe chest pain radiating to the back, often described as a ripping or tearing pain.

  • Hypertension
  • Syncope
  • paralysis of lower extremities
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7
Q

How would a dissecting aortic aneurysm show on a PE exam

A
  • Diminished or unequal peripheral pulses

- Possible diastolic murmur of Aortic Regurgitation

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8
Q

CXR of a dissecting aortic aneurysm may show what?

A

May reveal abnormal aortic contour or WIDENED

MEDIASTIMUM.

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9
Q

What is the imaging modality of choice to find an aneurysm?

A

CT with IV contrast

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10
Q

What is the goal when treating a dissecting aortic aneurysm?

A

lower blood pressure to SBP of 100-120 and lower HR to <80.

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11
Q

True/False
Type A aortic dissections do not require emergent surgery unless there is loss of blood flow to extremities or other organs

A

FALSE

REQUIRES EMERGENT SURGERY

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12
Q

Type B aortic dissections do not require emergent surgery unless what?

A

there is loss of blood flow to extremities or other organs

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13
Q

How would you treat an aortic aneurysm?

What is the mainstay of therapy?

A

ABCs, IV, O2 if saturation < 94%, Monitor

  • Beta blockers are mainstay of therapy.
    • Metoprolol 5 mg IV, or 50-100 mg orally
    • Labetalol 5-10 mg IV q 30 minutes to goal, or 100 mg q 6 hours orally
  • Pain control with Morphine 4-8 mg IV
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14
Q

Aneurysm

Long term management can use regular _____ medications in addition to beta blockers such as ACEI, ARB, Diuretics

A

antihypertensive

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15
Q

______ is the definitive therapy for Type A dissections

A

Surgery

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16
Q

Would you promote smoking cessation for a pt with aortic aneurysm?

A

yes……….

17
Q

Would you Medevac your aneurysm pt?

A

yes…………