Diseases of the Aorta Flashcards Preview

Clin Med - Cardio Exam #2 > Diseases of the Aorta > Flashcards

Flashcards in Diseases of the Aorta Deck (39)
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1

diameter of ascending, descending, and abdominal aorta

- ascending = 3cm
- descending = 2.5cm
- abdominal = 1.8-2.0cm

2

Why is the aorta prone to injury and dz?

constant exposure to high pulsatile pressures and shear stress

3

define aortic isthmus

- point where aortic arch joins descending aorta

4

Why is the aortic isthmus vulnerable to trauma?

- ductus arteriosus

5

How does the aorta change when we age?

- elasticity and distensibility decrease
- changes occur earlier and more rapidly in females
- decr elasticity is accelerated in pts w/ HTN, hypercholesterolemia, and CAD

6

define aortic aneurysms

- dilation of aorta anywhere
- all layers of vessel
- fusiform or saccular

7

difference b/t fusiform and saccular aneurysms

- fusiform = entire circumference
- saccular = outpouch

8

classifications of aortic aneurysms

- abdominal
- thoracic
- thoracolumbar

9

complications of aortic aneurysms

- dissections
- rupture

10

epidemiology of thoracic aneurysms

- avg growth = 0.1 - 0.2cm/yr, Marfan's grow faster
- rupture is related to size and presence of sx
- fewer than 1/2 of patients with an acute rupture arrive to the H alive

11

etiology of thoracic aneurysms

- ascending = MC is cystic medical necrosis
- aortic arch and descending = MC is atherosclerosis

12

risk factors of thoracic aneurysms

- atherosclerosis
- connective tissue d/o
- HTN
- familial thoracic aortic aneurysms
- infx: syphillis, TB
- vasculitis
- trauma

13

S+S of thoracic aneurysms

- asx
- if present, coinsicde w/ size + location
- +/- chest pain (usually when at risk of rupture)

14

What are specific S+S of aortic root, aortic arch, and descending thoracic aneurysms?

- aortic root = CHF, aortic regurg
- aortic arch = compress trachea and/or recurrent laryngeal n.
- desc = compress esophagus

15

diagnostics of thoracic aneurysms

- CXR
- TEE
- *CT*
- MRI
- aortography

16

treatment of thoracic aneurysms

- surgery (open v. endovascular stent)
- medical management: *BB*, ACE/ARB

17

define abdominal aortic aneurysms (AAA)

- greater than or equal to 3cm

18

epidemiology of AAA

- males more than females
- 90% = infrarenal

19

risk factors of AAA

- MC = atherosclerosis
- HTN
- smoking
- hypercholesterolemia
- PVD
- age
- male
- genetics

20

S+S of AAA

- mostly asx
- palpable, pulsatile, non-tender mass
- referred pain to abdominals or lower back

21

diagnostics of AAA

- *US*
- CT
- MRA

22

treatment of AAA

- *surgery* (indicated when symptomatic, greater than or equal to 0.5cm/yr, greater than or equal to 5.5cm diameter): prosthetic graft or endovascular stent
- decr smoking
- HTN + hypercholesterolemia control
- BB (decr. expansion + rupture)
- serioal imaging q6mo (vs. qyr for thoracic)

23

prevention/screening of AAA

- tx risk factors + decr smoking
- screen males 65-75 y/o who have ever smoked
- screen siblings + offspring

24

define aortic dissection

tear in intima leads to false channel in medial layer

25

How does an aortic dissection progress?

distally

26

What are the common sites of aortic dissection?

- right lateral wall of ascending aorta d/t shear stress
- descending, distal to ligamentum arteriosum

27

What is a result of aortic dissection?

- branching a. loose blood flow which leads to organ ischemia

28

epidemiology of aortic dissection

- 7th-8th decades
- males more than females

29

classification systems for aortic dissection

- DeBakey
- Stanford

30

risk factors for aortic dissection

- HTN
- age
- biscuspid aortic valve
- connective tissue d/o
- inflammatory aortitis
- pregnancy
- blunt trauma