AAA Flashcards
AAA
progressive, permanent, localized dilation of the abdominal aorta with aortic diameter of 3.0 cm or more, or a 50% increase in diameter compared with the adjacent normal segment.P
True aneurysm
Involves all 3 layers of the vessel
Fusiform
Symmetric weakness of the entire circumference of the vessel
Saccular
Only one side is weakened and bulges, from trauma to that side or weakness on that side
Pseudoaneurysm
A pseudoaneurysm, or false aneurysm, is an enlargement of only the outer layer of the blood vessel wall or the leak does not cause the vessel to bulge
AAA Risk Factors
Tobacco use Alcohol Use High cholesterol Hypertension Male gender Family history
Women are more likely to have an AAA rupture
AAA Presentation
Many are asymptomatic
Pain in abdomen, chest, groin may occur
Classic Triad - hypotension, pulsatile abdominal mass, abdominal or back pain
AAA Diagnosis
Aorta 3 cm or more
CT
AAA Screening
Men 60+ with first degree relative that had AAA need a ultrasound screening
Men 65 to 75 who have ever smoked need an ultrasound (though all men may benefit from this)
(Ever smoked = smoked 100 times in their entire life)
AAA Expansion
Most expand at rate of 0.2 to 0.3 cm per year, smoking increases risk of rupture
Rupture risk at 4 cm or more usually
AAA Management
HTN Control
Closely follow until surgical intervention needed
EVAR or surgical repair directly
AAA Education
After the detection of an AAA, patients should be counseled to report new-onset symptoms of aneurysmal enlargement, such as abdominal or back pain, to the vascular physician. Symptoms of impending rupture requiring immediate emergency care include severe abdominal pain, flank pain, or back pain unrelieved by position change. The abdominal pain may be characterized as deep, boring, or tearing. Low back pain may be dull, radiating to the legs, similar to musculoskeletal pain. The flank pain may radiate to the groin and be associated with hematuria.
