Aortic Disease - Pathophysiology, Presentation, Investigation & Therapy Flashcards Preview

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Flashcards in Aortic Disease - Pathophysiology, Presentation, Investigation & Therapy Deck (58):
1

What are examples of aortic diseases?

Atherosclerosis

Aneurysm

Coarctation

2

What are risk factors for atherosclerosis?

Hypertension

Hypercholesterolaemia

Smoking

Diabetes

Family history

Males more than females (until menopause)

3

Are males or females more at risk of atherosclerosis?

Males, until females undergo menopause

4

What can atherosclerosis lead to?

Stroke

Myocardial infarction

Aneurysm

5

What is an aneurysm?

Localised enlargement of an artery caused by a weakening of the vessel wall

6

What is a localised enlargement of an artery caused by a weakening of the vessel wall called?

Aneurysm

7

How can aneurysms be classified?

By being true or false, and by the site

8

What are examples of true aneurysms?

Saccular and fusiform

9

What is A?

True aneurysm

10

What is B?

Succular aneurysm

11

What is C?

Fusiform aneurysm

12

What is D?

False aneurysm

13

What is E?

Dissecting aneurysm

14

What is a true aneurysm?

Weakness and dilation of the wall, involving 3 layers

15

What are true aneurysms associated with?

Hypertension

Atherosclerosis

Smoking

Collagen abnormalities (such as Marfan's)

Trauma

Infection

16

What is a false aneurysm?

Rupture of the wall of the aorta with the haematoma either contained by the thin adventitial layer or the surrounding soft tissue

17

What is a false aneurysm associated with?

Inflammation (such as endocarditis)

Trauma

Iatrogenic

Thrill

Bruit

Pulsatile mass

Ischaemia

18

What are different classifications of aortic aneurysms by site?

Normal

Ascending aorta

Aortic arch

Descending aorta

Abdominal aorta

19

What are signs and symptoms of thoracic aneurysms?

Asymptomatic

Based on location:
Shortness of breath or even heart failure
Dysphagia and hoarseness (ascending aorta, chronic)
Sharp chest pain radiating to back (dissection)
Pulsatile mass
Hypotension

20

What is aortic dissection?

Tear in the inner wall of the aorta

21

What forces the walls apart in an aortic dissection?

Blood

22

What could an aortic dissection occlude?

Branches (such as mesenteric, carotid, renal or spinal)

23

What are the classifications of aortic dissection?

Type A (all dissections involving the ascending aorta, regardless of site of origin)

Type B (all dissections not involving the ascending aorta)

24

What are type A aortic dissections?

All dissections involving the ascending aorta regardless of site of origin

25

What are type B aortic dissections?

All dissections not involving the ascending aorta

26

What are aetiological factors for aortic dissection?

Hypertension

Atherosclerosis

Trauma

Marfan's syndrome

27

What are symptoms of aortic dissection?

Tearing, severe chest pain (radiating to back)

Collapse

Inferior ST elevation

28

What can be seen on the examination of aortic dissection?

Reduced or absent peripheral pulses

Hypo/hypertension

Soft early diastolic murmur

Pulmonary oedema

29

What investigations are done for aortic dissection?

Chest X-ray

Diagnosis can be confirmed by echocardiogram or CT

30

What can confirm the diagnosis of aortic dissection?

Echocardiogram or CT

31

What does the treatment of aortic dissection depend on?

Whether is is type A or B

32

What is the treatment for type A aortic dissection?

Surgery

33

What is the treatment for type B aortic dessection?

Meticulous blood pressure control

Sodium nitroprusside plus beta blocker

34

What could cause aortic dissection?

Infections and inflammation

35

What is an example of an infection that could cause aortic dissection?

Syphillis

 

36

What is an example of inflammation that could cause aortic dissection?

Takayasu's arteritis

37

What is Takayasu's arteritis?

Granulomatous vasculitis that affects aorta and main branches

38

Does Takayasu's arteritis affect more males or females?

Females

39

What are some causes of Takayasu's arteritis?

Stenosis

Thrombosis

Aneurysm

Renal artery stenosis

40

What is the treatment of Takayasu's arteritis?

Steroids

Surgery

41

What is syphilis?

STD caused by treponema pallidum

42

What is syphilis caused by?

Treponema pallidum

43

What are the different kinds of syphilis?

Primary and secondary

44

What can prevent the late stages of syphilis?

Antibiotics

45

What can congenital aortic aneurysm be caused by?

Bicuspid aortic valve

Marfan's syndrome

Coarctation

46

What are the problems of a bicuspid aortic valve?

Prone to stenosis and regurgitation

Associated with coarctation

47

What is the prevalence of bicuspid aortic valve?

1-2%

48

What is aortic coarctation?

Narrowing of the aorta

49

What is narrowing of the aorta called?

Aortic coarctation

50

What are the 3 associated shunts due to aortic coarctation?

Ductus arteriosus

Foramen ovale

Ductus venosus

51

Where does aortic coarctation occur?

Close to where the ductus arteriosus insets (ligamentum arteriosum)

52

What are the 3 types of aortic coarctation?

Pre-ductal

Ductal

Post-ductal

53

What are signs of coarctation?

Cold legs

Poor leg pulses

If before subclavian artery (radial-radial and righ radial-femoral delay)

If after subclavian artery (no radial-radial delay, right and left radio-femoral delay)

54

What are symptoms of coarctation?

Heart failure and failure to thrive in infancy

Hypertension in later life

55

What imaging is used to diagnosis aortic coarctation?

Chest X-ray

Chest MRI

56

What is Marfan's syndrome?

Genetic disorder that causes connective tissue weakness

57

What gene causes Marfan's syndrome?

Fibrillin 1 gene

58

What does Marfan's syndrome lead to?

Aortic/mitral valve prolapse or regurgitation

Skeletal system problems

Eye problems

Aneurysm, dissection (vascular problems)

Lung problems

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