Thoracic Aortic Aneurysm Flashcards
What is an aneurysm?
A persistent, abnormal dilation of an artery to 1.5x its normal diameter
What can a thoracic aortic aneurysm involve?
- The ascending aorta or aortic root
- Aortic arch
- Descending aorta
- Thoracoabdominal aorta segments
What % of thoracic aortic aneurysms involve the ascending aorta or aortic root?
What % of thoracic aortic aneurysms are in the aortic arch?
What % of thoracic aortic aneurysms are in the descending aorta?
What % of thoracic aortic aneurysms are in the thoracoabdominal aorta segments?
What is more common, abdominal or thoracic aortic aneurysms?
What has a higher mortality, abdominal or thoracic aortic aneurysms?
Why is the classification of aortic aneurysms important?
Because aneurysms in different locations present with different symptoms, and have different levels of surgical risk
What do thoracic aortic aneurysms develop due to?
Degradation of the tunica media
What is the tunica media?
The layer of the artery which provides tensile strength and elasticity to the wall
What is the result of the degradation of the tunica media in the thoracic aorta?
They artery looses structural integrity and dilates
What happens as the diameter increases in the development of thoracic aortic aneurysms?
The wall tension rises and further increases the diameter in a vicious cycle
What are the main causes of thoracic aneurysms?
- Connective tissue disease
- Bicuspid aortic valve
- Aortic dissection
- Aortic arteritis
- Tertiary syphillis
Give two examples of connective tissue diseases that can cause thoracic aortic aneurysms
- Marfan’s syndrome
- Erlers-Danlos syndrome
Why is there an increased risk of thoracic aortic aneurysm in patients with Turners syndrome?
Due to increased risk of bicuspid aortic valve
Give an example of an aortic arteritis
What is the mean rate of growth of thoracic aortic aneurysms?
When is the rate of growth of thoracic aortic aneurysms higher?
- Marfan’s syndrome
- Descending aneurysms
- Dissected aneurysm
What are the main risk factors for developing thoracic aortic aneurysms?
- Family history
- High BMI
- Male gender
- Advancing age
How are thoracic aneurysms typically found?
Incidentally - typically are asymptomatic
What is the most common presenting complaint in those with symptomatic thoracic aortic aneurysms?
Why is it important to know where the pain is in thoracic aortic aneurysms?
It can potentially localise the aneurysm
Where does an aneurysm in the ascending aorta cause pain?
Where does an aneurysm in the aortic arch cause pain?
Where does an aneurysm in the descending aorta cause pain?
Between the scapulae
What are the other symptoms of thoracic aortic aneurysms?
- Back pain
- Hoarse voice
- Distended neck veins
- Symptoms of heart failure
- Dyspnoea or cough
Which thoracic aortic aneurysms can cause back pain?
Descending or thoracoabdominal