Flashcards in Aortic aneurysms Deck (18):
Where does the aorta leave the heart?
Is the aorta an artery or vein?
What is an aneurysm?
Permanent localised dilation of an artery wall
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
Where do aortic aneurysms usually occur?
In the abdomen
What is an AAA?
Abdominal aortic aneurysm
What are the risk factors of AAA?
Connective tissue disease
How does smoking increase the risk of AAA?
Contains toxins that damage the aorta wall and cause it to stretch
How does atherosclerosis increase the risk of AAA?
Atherosclerotic plaques narrow the arteries
They stretch to counter this, stretching = aneurysm
Is there a screening programme for AAA?
Men, when they turn 65
An ultrasound scan to look at the aorta
What are the symptoms of an AAA?
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
What is the prognosis of a ruptured AAA?
If it is a large one often they don't make it to hospital or they don't survive reparative surgery
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
What surgery can be done to correct an AAA?
Replacement of aneurysm part of aorta with a prosthetic graft
Endovascular repair with insertion of aortic stent
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
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
Investigation of a dissecting aortic aneurysm.
CXR: shows a widened mediastinum
CT, trans ECHO, MRI can confirm diagnosis