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B3. Cardiovascular system > Thoracic Aortic Disease > Flashcards

Thoracic Aortic Disease Flashcards

1
Q

What are the different locations or classes of thoracic aneurysm?

A

Ascending Aorta
Aortic Arch
Descending Aorta
(After that your into Abdominal Aorta)

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2
Q

What are the types of aneurysm?

A

True & False

True aneurysms are split into saccular & fusiform

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3
Q

What is a true aneurysm?

A

Where all 3 layers of aortic wall are dilated.
One side = Saccular
All around = Fusiform

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4
Q

What is a false aneurysm?

A

Some or all of the wall layers rupture.

The haematoma is contained by the intact adventitia or surrounding soft tissue

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5
Q

What causes an aneurysm?

A

True:

  • Atherosclerosis
  • Connective Tissue Diseases (e.g. Marfan’s)
  • Trauma
  • Congenital Bicuspid Aortic Valve
  • Infections e.g. Syphilis

False:

  • Inflammatory Conditions (E.g. Takayasu’s Arteritis)
  • Trauma
  • Iatrogenic
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6
Q

Risk factors for an aneurysm?

A 
Age
Smoking
Marfan's etc.
Family History
Hypercholesterolaemia
Hypertension
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7
Q

What are the symptoms of a thoracic aortic aneurysm?

A

They vary with location and aer often asymptomatic but overall:

  • SOB
  • HF (if causing AR)
  • Dysphagia/Hoarseness (If chronic asc. aortic aneurysm)
  • Sharp Chest Pain radiating to Central upper back (spreads if dissection)
  • Regional Hypotension
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8
Q

What are the clinical signs of a FALSE aneurysm?

A

Thrill - Bruit - Pulsatile MAss

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9
Q

What are the possible outcomes/complications of an aneurysm?

A

Rupture.
Ischaemia/Infarction
Distal Emboli causing their own infarctions

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10
Q

What is Takayasu’s Arteritis?

A

Granulomatous Vasculitis affecting the aorta & its main branches

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11
Q

What are the conditions caused by takayasu’s Arteritis?

A 
Stenosis
Thrombosis
Aneurysms
Renal Artery Stenosis
Neurological Symptoms
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12
Q

Which gender is more affected by takayasu’s arteritis?

A

Women

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13
Q

How do we treat Takayasu’s Arteritis?

A

Steroids

Surgery

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14
Q

What is syphilis caused by?

A

The Treponema Pallidum Bacteria, its an STD

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15
Q

How does Syphilis become a cardiac problem?

A

without treatment it can develop to a tertiary stage in one of 3 forms:
Cardiac - Gummatous - Late-Neuro Syphilis

Cardiac Syphilis can cause AR and/or syphilitic Aortitis leading to aneurysm.

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16
Q

How do we prevent syphilis becoming serious and affecting cardiovascular system?

A

Antibiotics can prevent it progressing

17
Q

What is Aortic Dissection and how does it spread?

A

A tear in the inner aortic wall.
Blood then enters the tear and forces itself between the layers forming a false 2nd lumen that propagates up or down the aorta.

Chronic or acute

18
Q

What can cause aortic dissection?

A

Trauma - Cardiac Surgery - Marfan’s Syndrome - Bicuspid AV (congenital) - Atherosclerosis - Hypertension

19
Q

What are the risk factors for aortic dissection?

A

Trauma - Smoking - Pregnancy - Cocaine Use - Arteririts - Hypercholesterolaemia - Hypertension

20
Q

What are the symptoms of aortic dissection?

A

Chest Pain
Collapse
External Rupture Symptoms

21
Q

Describe the pain of aortic dissection?

A

Its a severe tearing pain that often radiates to the back if on desc. aorta. Position depends on site of the tear.

22
Q

Why does aortic dissetion cause collapse?

A

External rupture -> Tamponade restricting heart
External rupture -> Internal haemorrhage
Acute AR -> Collapse

23
Q

What happens if theirs an external rupture of aortic dissection?

A 
Pericardial Tamponade - SOB, pleuritic pain, weakness, dizziness & cough
Pleural Effusion (Haemothorax) - Pleuritic Pain, SOB.
24
Q

What are the clinical signs of aortic dissection?

A

Reduced/absent peripheral pulses

  • BP mismatch between limbs
  • AR murmur (soft, early diastolic)
  • Hyper/Hypotension
  • Pulmonary Oedema
  • Inferior ST elevation
25
Q

How do we investigate aortic dissection?

A

CXR - Mediastinal widening, loss of aortic knob, tracheal deviation, pleural effusion etc.
CTA/MRA - MRA is best
TOE - V common way to confirm diagnosis

26
Q

How do we treat aotic dissection?

A

Stanford Type B gets medical treatment

Stanford Type A gets surgery

27
Q

What medical treatment is there for Type B aortic dissection?

A

Beta Blockers
CCBs
Nitroprusside (vasodilator)

28
Q

What surgical treatment s there for Type A aortic dissection?

A

Valve and/or a section of aorta replacement.

29
Q

What are the possible complications of aortic dissection?

A

Rupturing into lumen, pericardium (tamponade) or Mediastinum (haemothorax)

Occlusion of important branches

30
Q

How will a dissected aorta appear histologically?

A

There will be a loss of elastin & muscle fibres with an accumulation of mucopolysaccharides in cyst-like spaces.

This is called ‘Cystic Medial Necrosis’

B3. Cardiovascular system (49 decks)

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