Thoracic aortic aneurysm

Question 1

What arteries can a thoracic aortic aneurysm be in?

Answer 1

Ascending aorta, aortic root, aortic arch, descending aorta or thoracoabdominal aorta

Question 2

Why do thoracic aortic aneurysms develop?

Answer 2

degradation of the tunica media which provides tensile strength and elasticity to the wall so the artery loses structural integrity and will dilate, so diameter increases and was tension rises and the diameter increases- viscous cycle

Question 3

What are the main causes of thoracic aortic aneurysms?

Answer 3

Connective tissue disorders, bicuspid aortic valve, trauma, aortic dissection, aortic arteritis, tertiary syphilis

Question 4

What are the risk factors for thoracic aortic aneurysm?

Answer 4

family history, hypertension, atherosclerosis, smoking high BMI, male gender advancing age

Question 5

What are the clinical features of a thoracic aortic aneurysm?

Answer 5

asymptomatic and found incidentally, pain, depending on site ascending will be anterior chest, aortic arch- neck, descending aorta between scapulae) back pain, hoarseness voice, distended neck veins, heart failure signs, dyspnoea and cough

Question 6

What are the differential diagnosis for a thoracic aortic aneurysm?

Answer 6

ACS, PE, Pneumothorax and aortic dissection

Question 7

What are the investigations for thoracic aortic aneurysms?

Answer 7

blood tests, ECG, Group and save, imaging such as a CXR, CT chest with contrast ( will show widened mediastinal silhouette, enlarged aortic knob and tracheal deviation) transoesophageal ECHO.

Question 8

What is the management for Thoracic aneurysms?

Answer 8

medical management such as statin and anti platelet therapy, blood pressure controlled and smoking stopped