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