Vascular: Aortic Dissection and Aneurysm Flashcards
Define aortic dissection
intimal tear with dissection of blood through media of aortic wall
where is the most common location for an aortic dissection
proximal 10 cm of aorta ( high stress region)
- with preexisting weakness of media
what is the most common cause of aortic dissection
- hypertension ( older adults )
- inherited defects of connective tissue (younger individuals)
How does hypertension cause aortic dissection
hyaline arteriolosclerosis of vasa vasorum
- decreased flow causes atrophy of media
what inherited connective tissue can cause aortic dissection
- Marfan syndrome
- Ehlers-Danlos
- both lead to weakness of connective tissue in media ( cystic medial necrosis)
how does aortic dissection present
sharp, tearing chest pain that radiates to the back
what are complications can arise from aortic disection
- pericardial tamponade
- rupture with fatal hemorrhage
- obstruction of branching arteries with resultant end-organ ischemia
what is the most common cause of death in aortic dissection
pericardial tamponade
what is thoracic aneurysm
balloon-like dilation of the thoracic aorta
what causes thoracic aneurysm ? what does this lead to?
weakness in aortic wall by tertiary syphilis
- endarteritis of vasa vasorum results in luminal narrowing, decreased blood flow, and atrophy of vessel wall
- results in tree-bark appearance of aorta
what is a major complication of thoracic aneurysm
- dilation of aortic valve root, resulting in aortic valve insufficiency
what are other complications of thoracic aneurysm
- compression of mediastinal structures ( airway, esophagus)
- thrombosis/embolism
What is Abdominal Aortic aneurysm ? where is it located
Balloon-like dilation of the abdominal aorta
- below the renal artery and above aortic bifurcation
what is a primary cause of abdominal aortic aneurysm
atherosclerosis
abdominal aortic aneurysm is commonly seen in who
male smoker greater than 60 years with hypertension
