vascular-aortic dissection and aneurysm

Question 1

where does an aortic dissection occur (which layer)?

Answer 1

media

Question 2

where along the aorta does an aortic dissection occur?

Answer 2

within proximal 10 cm of aorta (high stress region) with pre-existing weakness of media

Question 3

what is the most common cause of aortic dissection in adults? children?

Answer 3

htn in adults

connective tissue defect in children

Question 4

how does atrophy of the media occur in HTN

Answer 4

due to atherosclerosis of the vasa vasorum

Question 5

what 2 diseases classically lead to media weakenss

Answer 5

ehlers danlos

marfans

Question 6

how does aortic dissection present

Answer 6

sharp, tearing chest pain and radiates to the back

Question 7

what is the most common cause of death in someone with an aortic dissection

Answer 7

cardiac tamponade

Question 8

what vascular issue is tertiary syphilis classically assoc with

Answer 8

thoracic aneurysm

Question 9

you see a biopsy of a “tree bark appearance aorta” what do you think?

Answer 9

thoracic aneurysm

Question 10

what is a major complication of a thoracic aneurysm?

Answer 10

dilation of the aortic valve root resulting in aortic valve insufficiency

Question 11

where does an abdominal aortic aneurysm usually arrise

Answer 11

below the renal arteries but above bifurcation

Question 12

what is the classic patient with abdominal aortic aneurysm

Answer 12

male smoker greater than 60 with HTN

Question 13

how does atherosclerosis lead to vessel wall weakness?

Answer 13

atherosclerosis increases diffusion barrier to the media resulting in atrophy and weakness of vessel wall

Question 14

how does an abdominal aortic aneurysm rupture present (triad)

Answer 14

hypotension
pulsatile abdominal mass
flank pain