Thoracic Aortic Aneurysm article Flashcards
Definition of aortic aneurysm
50 % over normal diameter including all 3 layers
3 Layers of the vessel?
intima
media
adventitia
2 major types of aneurysms
Fusiform- uniform and symetrical involving the entire circumference of the vessel
Sacular- localized outpouching of any portion of the aortic wall
Classifications of thoracic aneurysms
ascending aortic aneursym - 60%
aortic arch - 10%
descending - 40 %
thoracoabdomina l- 10 %
Thoracoabdominal classifications
I. Proximal descending to proximal abdominal
II. Proximal decending to infrarenal
III. Dista descending with abdominal
IV. Primarily abdominal
CONFUSING A BIT!!!!
Thoracic aneurysms occur
age 60-70
Males 2-4 times more then females
HTN is present in 60% of cases
up to 13% have multiple aneurysms
Thoracic aneurysms most oftern result from
Cystic medial degeneration leading to wall weakening of the aortia
Syndroms associated with connective tissue disorders
Marfans syndrome
Ehlers-Danlos syndrome
The vast majority of Descending thoracic aneurysma are associated with
atherosclerosis
Most theroies believe it is a breakdown of what causing the weakening of the aortia
elastin and collagen by proteases
Aortic disection most often involves the
ascending and thoracic aorta
Aoric root dilation is mainly related to what syndrome
Marfans
Sinus of valsalva aneurysm can rupture into the R side of the heart causing a continuous ______ and in some cases ___________?
Murmur
Heartfailure
Errosion of an aneurysm into the mediastinum can cause what?
hoarseness due to compression of the L recurrent laryangeal nerve
hemidiaphramatic paralysis due to compression of the phrenic nerve
What is the perfered procedure to diagnosis of a aortic aneurysm per the ACC/AHA
ECHO (transthoracic perfered)
TEE if the above is incomplete
