Aortic aneurysms Flashcards Preview

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Flashcards in Aortic aneurysms Deck (18):
1

Where does the aorta leave the heart?

Left ventricle

2

Is the aorta an artery or vein?

Artery

3

What is an aneurysm?

Permanent localised dilation of an artery wall

4

What can happen as a result of an aneurysm?

Can be asymptomatic

Affect blood pressure

They can cause the vessel to rupture

Form a fistula

Source of emboli

5

Where do aortic aneurysms usually occur?

In the abdomen

6

What is an AAA?

Abdominal aortic aneurysm

7

What are the risk factors of AAA?

Male gender

Age

Smoking

Atherosclerosis

Hypertension

Family history

Connective tissue disease

8

How does smoking increase the risk of AAA?

Contains toxins that damage the aorta wall and cause it to stretch

9

How does atherosclerosis increase the risk of AAA?

Atherosclerotic plaques narrow the arteries

They stretch to counter this, stretching = aneurysm

10

Is there a screening programme for AAA?
Who? How?

Men, when they turn 65

An ultrasound scan to look at the aorta

11

What are the symptoms of an AAA?

Asymptomatic

Pressure on other structures can cause pain in the epigastric or back region

Unruptured AAAs usually found incidentally

If it ruptures there will be severe epigastric pain and hypovolaemic shock

12

What is the prognosis of a ruptured AAA?

Very poor
If it is a large one often they don't make it to hospital or they don't survive reparative surgery

13

What is the treatment of an AAA?

Unruptured: monitoring, modify lifestyle, surgery

Ruptured: emergency surgery, treat hypovolaemic shock
Do ECG, crossmatch blood, prepare for surgery

14

What surgery can be done to correct an AAA?

Replacement of aneurysm part of aorta with a prosthetic graft

OR

Endovascular repair with insertion of aortic stent

15

What is a dissecting aortic aneurysm?

When a tear in the tunica intima of the aorta causes blood to flow between the layers of the wall of the aorta, forcing the layers apart

16

How would a patient with a dissecting aortic aneurysm present?

Abrupt onset of severe, tearing, central chest pain which radiates through to the back

Other symptoms that result from decreased blood supply to other organs:
- neurological signs
- absent or uneven pulses or BP in arms

17

Investigation of a dissecting aortic aneurysm.

CXR: shows a widened mediastinum

CT, trans ECHO, MRI can confirm diagnosis

18

Management of a dissecting aortic aneurysm.

Emergency surgery

Crossmatch blood
Admit to ITU
Try to bring BP down