Diseases of the Aorta Flashcards Preview

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Flashcards in Diseases of the Aorta Deck (21):
1

True aneurysm

Dilatation of all three layers of the aorta (can be saccular or fusiform)

2

False aneurysm

Contained rupture through intima and media, contained by adventitia or by a perivascular clot

3

Etiology of Ascending Aortic Aneurysm

Cystic medial necrosis

Caused by Marfans, Ehlers-Danlos Syndrome, Bicuspid valve

SYPHILIS

4

Etiology of Descending Aortic Aneurysm

Atherosclerosis

5

Risk factors for Abdominal Aortic Aneurysm

Hypertension, age, smoking, family history, hyperlipidemia

6

Do abdominal aortic aneurysms expand?

Yes! by 1/4 mm/year.

Expand faster if active smoker, hypertensive

7

Risk of AAA rupture is related to...?

Size. If greater than 5.5 surgery immediately.

8

Presentation of aortic aneurysm

Most commonly asymptomatic. Can get compression of local structures (cough, dyspnea, dysphagia, horseness). Can get aortic regurgitation/CHF.

9

How to treat aortic aneurysm

B blockers to decrease BP and hemodynamic stress
ACEis- decrease afterload/preload
ARBs - decrease afterload/preload
Smoking cessation

Surgical repair

10

Aortic dissection

Life threatening condition where blood from the vessel lumen passes through an intimal tear and creates a new lumen in the media.

11

Type A vs Type B aortic aneurysm

A is ascending.

B is descending only

12

Related syndromes to aortic dissection

Penetrating ulcer or intramural hematoma

13

2 proposed mechanisms for pathogenesis of aortic dissection

Tear in the intima causes blood to enter media

Rupture of vasa vasorum causes hemorrhage into the media

14

When are aortic dissections most common?

In the sixth and seventh decades in men

15

Risk factors for aortic dissection

Hypertension, tobacco smoking, cocaine, connective tissue disorders, bicuspid aortic valve, aortic coarctation

16

Symptoms of aortic dissection

Type A: Severe tearing chest pain at chest
Type B: Severe tearing chest pain between scapulae

17

How to treat aortic dissection

Immediate treatment required. Beta blocker administration, nitroprusside to vasodilate.

18

Complications of rupture of aortic dissection

Tamonade, hemothorax, stroke, MI, renal failure.

19

PAD risk factors

Age, hypertension, smoking, hyperlipidemia, family history

20

Is PAD a CHD risk equivalent?

Yes.

21

Cilostazol

Vasodilator/platelet inhibitor to treat PAD.