Throaci Aortic Aneurysm Flashcards
What are risk factors for throacic aortic aneurysm?
- Advanced age
- Arterial hypertension
- Trauma
- Tertiary syphilis (due to obliterative endarteritis of the vasa vasorum)
- Connective tissue diseases (e.g., Marfan syndrome, Ehlers-Danlos syndrome)
- Bicuspid aortic valve
What type of infection can cause thoracic aortic aneurysm?
Syphilis
What type of inflammatory process can cause thoracic aortic aneurysm?
Takayasu’s arteritis
What is takayasus arteritis?
https://www.youtube.com/watch?v=fKXHxcV6eLU
Granulomatous giant cell vasculitis which causes stenosis and aneurysms in the branches of the aortic arch, particularly around the branch points.
What are congenital causes of Thoracic aortic aneurysm?
- Bicuspid aortic valve
- Marfan’s Syndrome
- Coarctation of the Aorta
What are is bicuspid Aortic Valve?
Normal Aortic Valve has 3 leaflets, bicuspid has 2
What are signs/symptoms of thoracic aortic aneurysm?
Mostly Asymptomatic, but if symptomatic:
- Feeling of pressure in the chest
- Thoracic back pain
-
Features of mediastinal compression/obstruction
- Cough, wheeze, stridor (trachea)
- Difficulty swallowing (esophagus)
- Upper venous congestion (superior vena cava syndrome)
- Hoarseness (recurrent laryngeal nerve)
What is the most common pathophysiological cause of ascending throacic aortic aneurysm?
Cystic medial necrosis
What is the most common pathophysiological cause of descending throacic aortic aneurysm?
Atherosclerosis
What investigations would you consider for a suspected thoracic aortic aneurysm?
- Chest x-ray - bulging of aortic knob, widened mediastinum, tracheal elevation
- CT with contrast
What is the best confimatory test for TAA?
Chest CT with contrast
How would you manage TAA?
- Reduction of CVS risk factors
- Surgery - if symptomatic
What are complications of thoracic aortic aneurysm?
- Aortic dissection
- Rupture
What are risk factors for rupture of a TAA?
- Large diameter
- Rapid expansion
- Trauma
