Abdominal Aortic Aneurysm Flashcards
Define Abdominal Aortic Aneurysm
It is when there is permanent irreversible dilatation of the abdominal aorta. >3cm.
Where do most AAA happen
90% of AAAs occurs infrarenally (Below level of renal arteries)
What are the other places that can have aneurysms
Thoracic, illiacs, femoral, and popliteal arteries
What is a true aneurysm
Involves all levels of arterial wall
What is a false aneurysm
psuedoanerysms involves a collection of blood in the outer layer only (adventitia) which communicates with the lumen
Epidemiology Abdominal Aortic Aneurysm
Incidence increases with age
present in 3% of population >50yrs
3M:1F
8:1 in smokers
mainly affects Caucasians
Less common in diabetics
Causes of Abdominal Aortic Aneurysm
Atherosclerosis - commonest cause of true peripheral artery aneurysm
Trauma
Infection
Connective tissue disorder (Marfan’s)
Inflamatory
Risk factors of Abdominal Aortic Aneurysm
Smoking (x8)
Male
Fx
Age
HTN
Hyperlipidaemia
COPD
DM
Symptoms of Abdominal Aortic Aneurysm
Intermittent or continous abdominal pain radiates to the back illiac fossae or groin, DONT DISSMISS THIS AS RENAL COLIC
Collapse
A 65 year old man collapses in the street. He has an umbilical mass that is expansile and pulsatile
AAA
Signs of Abdominal Aortic Aneurysm
An expansile abdominal it expands and contracts swelling that is pulsatile
Shock
Hypotension
Differentials of Abdominal Aortic Aneurysm
Acute abdomen
Investigate of Abdominal Aortic Aneurysm
FBC
Clotting
Renal function
Liver function
Cross match for surgery
ESR/CRP
ECG
Imaging
USS
CT
MRI angiography
Put in 2 cannulas, call a vascular surgeon and anesthetist
Conservative management of Abdominal Aortic Aneurysm
For asymptomatic AAAs where risk of repair is higher than risk of not treating
modify and treat risk factors
treat underlying causes
regular monitoring
DVLA notified if >6cm, 6.5cm, disqualifies person from driving
Medical management of Abdominal Aortic Aneurysm
Some evidence suggest small aneurysms can be reduced by drugs:
Doxycycline
Roxithromycin
ACE
Losartan
Statins
low-dose aspirin
