Peripheral Vascular Disease Flashcards
You diagnose a patient with PVD and she asks you how she could’ve developed this disease. How do you answer?
- Structural changes in vessel wall
- Narrowing of vascular lumen
- Spasm
What is the normal diameter of the aorta from the base of the heart?
3 cm from origin at base of heart
A patients ascending aorta is 7cm. Is this normal?
No. The normal ascending aorta diameter is 5 – 6 cm length
A patients descending aorta is 1cm. Is this normal?
No. The normal descending aortal diameter 2 – 2.5 cm
If a patients abdominal aorta is 1.8–is this ok?
Yes: Narrows 1.7 – 1.9 cm
As the aorta pierces the diaphragm, it becomes the abdominal aorta
What is an Aortic aneurysm?
Abnormal localized dilatation of an artery
Diameter has increased by at least 50% compared with normal
T/F: A TRUE aortic aneurysm is a dilation of all 3 layers.
True
What is a fusiform aortic aneurysm?
Fusiform – symmetrical dilation of entire circumference (most common)
What is a saccular aneurysm?
localized out-pouching involving only a portion of circumference
What is the most common type of aortic aneurysm?
Fusiform
What is a False/Pseudoaneurysm?
Contained rupture of the vessel wall–
–that develops when blood leaks out of the vessel lumen
–through a hole in the intimal and medial layers
–and is contained by layer of adventitia or perivascular organized thrombus
Where do pseudo aneurysms develop? Are they stable?
Develop at sites of vessel injury – infection, trauma, puncture
No; they are very unstable and prone to rupture
A patient has an ascending aortic aneurysm, what are some possible causes?
Aging
HTN
Connective tissue disorders (Marfan’s)
Bicuspid aortic valve
If a patient had atherosclerosis and its associated risk factors, what could this ultimately cause?
Descending thoracic and abdominal aortic aneurysms
T or F: Ascending aortic aneurysms are more common in women
False
More common in men
You suspect your male patient has an aortic aneurysm, what type is it most likely to be?
Fusiform
often extend into the aortic arch
What condition predisposes patients to an aneurysm and dissection?
Bicuspid aortic valve
Where do descending thoracic aortic aneurysms begin?
Often begin distal to left subclavian artery
A patient with a descending thoracic aortic aneurysm may have what other predisposing condition?
Coarctation of the aorta
What is the most common type of descending aortic aneurysm?
Fusiform
Where are >90% of abdominal aneurysms?
distal to the renal arteries
“infrarenal abdominal aneurysms”
What are the risks for an AAA?
1. Smoking increases risk 8x in ADAM 2. HTN present in 40% of patients 3. Family history and presence of COPD are also cofactors 4. Cholesterol may play a role
What are some other causes of true aneurysms?
- Infection
2. Vasculitis – Takayasu arteritis, giant cell arteritis
When a patient has a symptomatic aortic aneurysm, what are the symptoms most likely attributed to?
compression of other structures