Aortic Disease

Question 1

state the classes of aortic aneurysms (classified by site)

Answer 1

ascending aorta aneurysm
aortic arch aneurysm
descending aorta aneurysm
abdominal aorta aneurysm

Question 2

what is an especially serious aortic aneurysm

Answer 2

an ascending aorta aneurysm

Question 3

what are the symptoms of an ascending aorta aneurysm

Answer 3

dull pain of the chest
tenderness in the chest
cough
hoarseness
shortness of breath
pain in the back, jaw or neck

Question 4

what are the causes/risk factors of ascending aorta aneurysms

Answer 4

heart disease
older age
family history
genetics
infection

Question 5

what are the imaging tests to detect an aortic aneurysm

Answer 5

ECHO
CT scan
MRI angiography

Question 6

what are the methods of treatment of an aortic aneurysm

Answer 6

open surgery
endovascular surgery
emergency surgery

Question 7

describe an abdominal aorta aneurysm

Answer 7

it is an enlarged area in the lower part of the aorta, it is a bulge or swelling that can be dangerous

Question 8

what are the signs of symptoms of thoracic aneurysms based on the location of the aneurysm

Answer 8

shortness of breath
heart failure
aortic regurgitation
dysphagia and hoarseness - ascending aorta aneurysm or chronic aneurysm
sharp chest pain radiating to the back between the shoulder blades
pulsatile mass
hypotension

Question 9

what is aortic dissection

Answer 9

it is a serious condition in which the inner layer of the aorta tears

Question 10

describe aortic dissection

Answer 10

blood surges through the tear in the aorta, causing the inner and middle layers of the aorta to separate - dissect

Question 11

describe aortic arch dissection

Answer 11

it is either a dissection limited to the aortic arch or a dissection arising distal to the origin of the left subclavian artery and extending proximally into the arch but not involving the ascending aorta

Question 12

what are type A Stanford thoracic aortic dissections

Answer 12

they are dissections involving the ascending aorta, regardless of the site of origin

Question 13

what are type B Stanford thoracic aortic dissections

Answer 13

they are dissections not involving the ascending aorta

Question 14

what are the 2 most common classification systems of thoracic aortic dissection

Answer 14

Standford and DeBakey

Question 15

what are type 1 DeBakey thoracic aortic dissections

Answer 15

they are dissections that originate in the ascending aorta and propagates at least to the aortic arch

Question 16

what are type 2 DeBakey thoracic aortic dissections

Answer 16

they are dissections that originate in and are confined to the ascending aorta

Question 17

what are type 3 thoracic aortic dissections

Answer 17

they are dissections that originate in the defending aorta and extend distally down the aorta

Question 18

state 4 etiological factors of dissection

Answer 18

hypertension
atherosclerosis
trauma
Marfan’s syndrome

Question 19

state symptoms and signs of aortic dissection

Answer 19

tearing, severe chest pain radiating to the back
collapse
tamponade
acute aortic regurgitation
external rupture
inferior ST elevation
around 50% mortality prehospital admission
reduced or absent peripheral pulses
hypotension
hypertension
soft early diastolic murmer
aortic regurgitation
pulmonary oedema
CXR - shows widened mediastinum

Question 20

describe the treatment of aortic dissection

Answer 20

surgery
meticulous blood pressure control
sodium nitroprusside

Question 21

state an infection relating to the aorta

Answer 21

syphillis

Question 22

state inflammation relating to the aorta

Answer 22

Takayasu’s arteritis

Question 23

what is Takayasu arteritis

Answer 23

it is rare, systemic, inflammatory, large-vessel vasculitis with unknown aetiology, it is defined as granulomatous inflammation of the aorta and its major branches and most commonly affects woman of childbearing age

Question 24

what is bicuspid aortic valve

Answer 24

it is an inherited form of heart disease

Question 25

describe bicuspid aortic valve

Answer 25

2 of the leaflets of the aortic valve fuse during development in the womb resulting in a 2 leaflet valve instead of the normal 3 leaflet valve bicuspid aortic valve instead or tricuspid

Question 26

what is a bicuspid aortic valve associated with

Answer 26

coarctation

Question 27

what does having a bicuspid aortic valve make you prone to

Answer 27

``` aneurysm dissection stenosis regurgitation an abnormal aorta reduced tensile strength ```

Question 28

what is coarctation of the aorta also described as

Answer 28

aortic narrowing

Question 29

what is coarctation of the aorta

Answer 29

it is a congenital condition whereby the aorta is narrow

Question 30

where is coarctation of the aorta most common

Answer 30

in the aortic arch

Question 31

state the 3 shunts of coarctation

Answer 31

ductus arteriosus foramen ovale ductus venosus

Question 32

state the 3 types of coarctation

Answer 32

pre ductal ductal post ductal

Question 33

where does coarctation usually occur

Answer 33

in the area where the ductus arteriosus inserts

Question 34

what type of coarctation can be life threatening if the narrowing is severe

Answer 34

pre ductal coarctation

Question 35

what are the signs of coarctation

Answer 35

cold legs poor leg pulses radial-radial delay and right radial-femoral delay if the coarctation occurs before the left subclavian artery no radial-radial delay and right and left radio-femoral delay if the coarctation occurs after the left subclavian artery

Question 36

state symptoms of coarctation

Answer 36

``` chest pain cold feet or legs dizziness or waiting decreased ability to exercise failure to thrive leg cramps with exercise nosebleed poor growth ```

Question 37

what can be used to detect the location and severity of aortic coarctations

Answer 37

ECHO

Question 38

what is Marfan's syndrome

Answer 38

it is a genetic disorder that affects the body's connective tissue

Question 39

what are the signs/features of Marfan's syndrome

Answer 39

``` tall and slender build disproportionately long arms, legs and fingers a breastbone that protrudes outward or dips inward a high, arched palate and crowded teeth heart murmurs extreme nearsightedness an abnormally curved spine flat feet ```