AORTIC ANEURYSM THORACIC AORTIC ANEURYSM and ABDOMINAL AORTIC ANEURYSM Etiology Symptoms with Treatment

AORTIC ANEURYSM Etiology Symptoms with Treatment

  • Aneurysm is a pathological dilatation of a seg­ment of vessel.
  • An aneurysm affecting any part of the aorta from the aortic valve to the iliac arteries.
  • True aneurysm involves all 3 layers of an ar­tery or vein or heart.
  • Pseudo aneurysm is a breakage of intima and media of the blood vessels, sometimes contain­ing a clot, and lined by adventitial layer.
  • A fusiform aneurysm is a diffusely dilated aneu­rysm.
  • A saccular aneurysm is a bulging of the vessel
  • wall.

AORTIC ANEURYSM

AORTIC ANEURYSM Etiology Symptoms with Treatment

Aneurysm may be abdominal or thoracic.

Etiology :

  • Atherosclerosis
  • Cystic medial necrosis -as in Marfan syndrome, Ehlers-Danlos syndrome etc.
  • Thoracic aneurysms occur most commonly in the sixth and seventh decade of life.
  • Hypertension is an important risk factor, being present in over 60 percent of patients
  • Syphilis
  • Tuberculosis
  • Mycotic aneurysm (An aneurysm dU~jo_staphy­lococcal,~treP-tococcal or salmonella infection qf the aorta gn a plaque~ .
  • these are infected saccu­[ar aneurysl1Js).
  • Takayasu disease Trauma Congenital Vasculitis.

Types —

  • Thoracoabdominal aneurysms — 10 %
  • Descending aortic aneurysms distal to the left subclavian artery — 40%
  • Ascending aortic aneurysms arise anywhere from the aortic valve to the innominate artery — 60%
  • Aortic arch aneurysms include any thoracic aneurysm that involves the brachiocephalic vessels — 10 %

THORACIC AORTIC ANEURYSM

Usually asymptomatic Symptoms

  • Chest pain
  • Dyspnoea
  • Cough
  • Dysphagia.
  • -AR
  • CHF
  • Superior vena cava
  • syndrome.

Investigations

  • X-ray chest
  • – 2D echocardiography
  • – TEE – trans esophageal
  • echocardiography
  • – CT
  • – MRI
  • – Aortography .

Treatment

  • Beta blockers
  • Antihypertensives
  • Prosthetic grafts
  • Other surgeries.

ABDOMINAL AORTIC ANEURYSM

  • aneurysm is a focal dilation of a blood vessel with respect to the original or adjacent artery
  • More common in elderly males
  • Abdominal aortic aneurysm occurs four to five times more commonly in men than women ,
  • The aneurysm is usually below the level of renal arteries
  • Peripheral embolization is common due to ath­erosclerosis
  • Abdominal aortic aneurysm in more common in patients with atherosclerosis
  • Usually asymptomatic.

Investigations:

  • X-ray abdomen –
  • Ultrasound
  • – CT, MRI
  • – Aortography.

Treatment

  • Operative repair if diameter of aneurysm more than 5.5 em.
  • Prosthetic graft, endovascular stents.