Diseases of the Aorta Flashcards
(39 cards)
diameter of ascending, descending, and abdominal aorta
- ascending = 3cm
- descending = 2.5cm
- abdominal = 1.8-2.0cm
Why is the aorta prone to injury and dz?
constant exposure to high pulsatile pressures and shear stress
define aortic isthmus
- point where aortic arch joins descending aorta
Why is the aortic isthmus vulnerable to trauma?
- ductus arteriosus
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
define aortic aneurysms
- dilation of aorta anywhere
- all layers of vessel
- fusiform or saccular
difference b/t fusiform and saccular aneurysms
- fusiform = entire circumference
- saccular = outpouch
classifications of aortic aneurysms
- abdominal
- thoracic
- thoracolumbar
complications of aortic aneurysms
- dissections
- rupture
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
etiology of thoracic aneurysms
- ascending = MC is cystic medical necrosis
- aortic arch and descending = MC is atherosclerosis
risk factors of thoracic aneurysms
- atherosclerosis
- connective tissue d/o
- HTN
- familial thoracic aortic aneurysms
- infx: syphillis, TB
- vasculitis
- trauma
S+S of thoracic aneurysms
- asx
- if present, coinsicde w/ size + location
- +/- chest pain (usually when at risk of rupture)
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
diagnostics of thoracic aneurysms
- CXR
- TEE
- CT
- MRI
- aortography
treatment of thoracic aneurysms
- surgery (open v. endovascular stent)
- medical management: BB, ACE/ARB
define abdominal aortic aneurysms (AAA)
- greater than or equal to 3cm
epidemiology of AAA
- males more than females
- 90% = infrarenal
risk factors of AAA
- MC = atherosclerosis
- HTN
- smoking
- hypercholesterolemia
- PVD
- age
- male
- genetics
S+S of AAA
- mostly asx
- palpable, pulsatile, non-tender mass
- referred pain to abdominals or lower back
diagnostics of AAA
- US
- CT
- MRA
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)
prevention/screening of AAA
- tx risk factors + decr smoking
- screen males 65-75 y/o who have ever smoked
- screen siblings + offspring
define aortic dissection
tear in intima leads to false channel in medial layer
