Lecture 8: Aortic Disease Flashcards
RF for patient populations for anyeursm
- Marfans
- Erlos-Danlos
- BAV
- turner’s
- coarctation of the aorta
which lab test rules out dissection
d-dimer < 500
imaging for dissection
CT/MRI if stable
unstable - CT or TTE/TEE
medical tx dissection
Type A- root - surgery
Type B - medical therapy
- IV BB (keep BP < 120), + IV nitroprusside to keep HR < 60-70
referral to thoracic/ abdominal surgery anyeursm
- > 5.5 cm
- > 0.5 cm every 6 months
- symptoms of compression
murmur for dissection
- low pitch diastolic murmur for aortic regurgitation
2. or crescnedo-decrescendo systolic murmor of BAV
acquired inflammation of aortic root
- Syphillis
- Takayasu
- giant cell
who should be considered to 5.0 cm thoracic root
- Marfan
- women considered pregnancy
- BAV
AAA screening
one-time ultrasonographic screening in men aged 65 to 75 years who are active or former smokers
TX AAA ANYEURMS
Elective repair should be considered for AAA of 5.5 cm in diameter, for those that increase in diameter by more than 0.5 cm within a 6-month interval, and for those that are symptomatic (tenderness or abdominal or back pain).
if AAA is big, how often
> 4.0, then annually
surveillance AAA in Marfan’s
American College of Cardiology Foundation/American Heart Association guidelines recommend follow-up imaging 6 months after diagnosis, with annual surveillance thereafter if the aortic root is less than 4.5 cm in diameter and otherwise stable.
main complication for endovascular repair of anyeursm
endoleaks
Minor criteria Dukes
Fever Immunological Crtiera VAscular embolia Predisposition Micro
+ dukes
2 Major (+ blood + evidence of endocardial involvement) + 5 Minor
or
1 M and 3 minor
