Vascular: AAA Flashcards
What is an abdominal aortic aneurysm
Dilation of abdominal aorta greater than 3cm
RF for AAA?
Male
Increased Age
Smoking
Hypertension
Family history
Existing CVS disease
Screening for AAA
All men in England at age 65 offered screening.
Pts with aortic diameter over 3cm referred to vascular team
Investigations for AAA
US is initial diagnosis
CT angiogram gives more detailed picture of aneurysm for repair
Management AAA
Risk of progression:
Stop smoking
Healthy diet and exercise
Optimising mx of hypertension, diabetes, hyperlipidaemia
Surveillance:
Yearly for pts with aneurysm 3-4.4cm
3monthly for pts with 4.5-5.4cm
Elective repair for patients:
greater than 5.5cm
Symptomatic aneurysm
Growing more than 1cm a year
Classification of AAA
No aneurysm- less than 3 cm
Small aneurysm- 3-4.4cm
Medium aneurysm- 4.5-5.4cm
Large aneurysm- above 5.5cm
Presentation of ruptured AAA
Severe abdo pain radiating to back or groin
Haemodynamically unstable (hypotension and tachycardia)
Pulsatile and expansile mass in abdo
Collapse
LOC
Driving rules for AAA?
Inform DVLA if aneurysm is above 6cm
Stop driving is above 6.5cm
Stricter rules if driving heavy vehicle
What is permissive hypotension in AAA management?
Allowing lower than normal blood pressure when fluid resuscitating as increased BP= increased blood loss
