Vessel Aneurysms Flashcards
What is a vessel aneurysm?
wall stress>
weakening of the vessel wall>
dilation
What is the most common vessel aneurysm?
AAA
Men > 60
Tenth leading cause of death in men > 65
Where are AAA usually located?
BELOW the renal artery orifices
What causes AAA?
Atherosclerosis>
weakened wall>
dilation of vessel
A pt with an AAA may have what clinical findings?
- asymptomatic
- pulsatile epigastric mass (tender/nontender)
- bruit (renal artery stenosis/visceral stenosis present
What is the most common complication of an AAA? What is the triad for rupture?
RUPTURE
Left flank pain
hypotension
pulsatile mass
What is the greatest predictor of rupture?
Diameter of the aneurysm
>5–> surgical repair
How do you diagnose AAA?
Ultrasound
What is a popliteal artery aneurysm?
Male dominant
Behind Knee
What is the most common peripheral aneurysm?
popliteal
What is a mycotic aneurysm?
vessel wall thickening d/t an infection
What fungi commonly cause mycotic aneurysm?
Aspergillus, Candida, Mucor (invade vessels and weaken them)
What bacteria commonly cause myoctic aneurysm?
BActerioides fragilis, pseudomonas, salmonella
What is a berry aneurysm?
Saccular dilation found around circle of willis at the base of the brain
What is a syphilitic aneurysm?
T. Pallidum
Aortic arch aneurysm
Tertiary syphilis
vasa vasorum vasculitis
What type of vasculitis is associated with a syphilitic aneurysm?
Endarteritis obliterans: plasma cell infiltrate
What clinical findings are associated with a syphilitic aneurysm?
AV regurge
Early diastolic murmur
Wide pulse pressures–> bounding
What murmur is commonly observed with syphilitic aneurysm?
Austin Flint murmur: blood dripping onto anterior MV leavlet
What population is aortic dissection most commonly observed in?
Men 40-60 yrs w/ HTN
What is the most common cause of death in Marfan syndrome/EDS?
Aortic dissection
What is the pathology behind aortic dissection?
Cystic medial degeneration
Elastic tissue fragmentation in media> weak elastic artery
What are risk factors for cystic medial degeneration?
- Increased wall stress (HTN, pregnancy, coarcation of the aorta)
- Defects in CT (marfans, EDS)
What causes an intimal tear in the aorta?
HTN/underlying structural weakenes>
tear w/in 10 cm of AV>
blood dissects under arterial pressure through areas of weakness
What are clinical findings of aortic dissection?
Pain radiates to back
absent pulse
AV regurge
What is the MCC of death in aortic dissection?
cardiac tamponade
